Meningioma- cerebellopontine angle

Case contributed by Dr Ammar Haouimi

Presentation

Left trigeminal neuralgia.

Patient Data

Age: 65 years
Gender: Female

The MRI sequences demonstrate an extra-axial dural-based mass (20 x 18 x 16 mm) of the left cerebellopontine angle located above the internal auditory canal (IAC) in contact with the anteromedial margin of the tentorium cerebelli with a mass effect on the cisternal segment of the ipsilateral trigeminal nerve and middle cerebellar peduncle. It shows an isosignal to the cortical grey matter on T1, T2, and FLAIR with a central area of low signal on all sequences (calcification). The postcontrast sequences show a vivid homogeneous enhancement of the non-calcified component.

  No significant mass effect on the ipsilateral VII and VIII cranial nerves.

Case Discussion

MRI features are most consistent with a CPA meningioma compressing the cisternal segment of the left trigeminal nerve.

On imaging, the main differential diagnoses are acoustic schwannoma and trigeminal schwannoma.

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