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Meningioma

Case contributed by Tarek Moustafa Essam Daoud
Diagnosis almost certain

Presentation

Headache and attacks of loss of conciousness.

Patient Data

Age: 35 years
Gender: Male
mri

A sizable extra-axial left cerebellar space-occupying lesion is noted with the following criteria:

  • epicentered on the left tentorial leaflet with a broad enhancing dural tail attachment

  • it measures 5.6 x 5.4 x 5.2 cm in maximum dimensions.

  • expressing T1, T2 and FLAIR isointense signal

  • it showed avid homogenous post-contrast enhancement.

  • no evidence of restricted diffusion or SWI blooming

  • mild peri-focal edema

  • mass effect in the form of:

    • buckling of the related cortical gyri

    • compression of the 4th ventricle with contra-lateral midline shift with subsequent supra-tentorial ventricular dilatation with minimal peri-ventricular CSF permeation

    • tonsillar herniation with effacement of the medullo-cervical junction

Case Discussion

Overall imaging features are impressive of left tentorial meningioma.

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