Presentation
Sustained a fall. IC bleeding?
Patient Data
- no sign of IC bleeding or bony trauma
- Incidentally the structure of the right petrous apex appears inhomogeneous, with an adjacent 20 mm sclerotic lesion
- widened right foramen ovale, expanded by the calcific mass
Findings suggestive of meningioma, planned MRI recommended.
an about 27 x 25 mm, inhomogeneous low signal extraaxial mass is visible adjacent to the petrous apex
The lesion widens the foramen ovale, and extends into the pterygoid space greatest craniocaudal dimension reaching 40 mm
inhomogeneous enhancement post contrast
note resultant ipsilateral muscle atrophy, best seen in the depicted masseter, likely due to secondary denervation
mild chronic small vessel ichemic changes and état criblé appearance of the basal ganglia
mild vertebrobasilar dolichoectasia
Case Discussion
Meningiomas can demonstrate extracranial spread via the skull base foramina, thus careful assessment of the structures is necessary if the lesion is situated close to them.
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