Meningiomas - cerebellopontine angle and parafalcine

Case contributed by Dr Ammar Haouimi

Presentation

Left peripheral facial nerve palsy.

Patient Data

Age: 75 years
Gender: Female

The MRI sequences demonstrate two well-defined extra-axial broad-based masses.

In the left cerebellopontine angle at the posterior margin of the porus acusticus internus, a mass shows moderate hyperostosis. It appears isointense to the cortical grey matter on both T1, T2, and FLAIR with homogeneous enhancement on postcontrast sequences. No mass effect on the adjacent facial nerve or vestibulocochlear nerves

A second mass is seen in the left parietal parasagittal region abutting the superior sagittal sinus. It shows an isosignal to the cortical grey matter on T1, low signal on T2, FLAIR and GE mainly centrally (most likely calcified component) with homogeneous enhancement of the peripheral component and dural tail sign. The adjacent portion of the superior sagittal sinus is compressed with no evidence of invasio

Case Discussion

MRI features of two enhancing broad-based extra-axial masses of the left cerebellopontine angle and left parietal parasagittal region most consistent with meningiomas (most likely incidental findings in this case). No cause for facial nerve palsy identified. 

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