Presentation
History of trauma to the left eye about 3 years back, now complaining of headache for 2 months.
Patient Data
There is a well-defined, extra-axial lesion which is measuring 3.1 x 3.4 x 1.7 cm (AP x TRANS x CC) in size and is arising from planum sphenoidale; returning signals are isointense to cortical grey matter on T1 WIs and FLAIR images and mildly hypointense on T2 WIs which shows homogenous post-contrast enhancement along with positive dural tail sign. Minimal surrounding edema is also seen. The mild mass effect manifests as compression of inferior aspects of the bilateral frontal lobes.
A small, well-defined lesion is noted in the sub-cortical location of the left parietal region, returning signals are hypointense on T1 WI, hyperintense on T2, and T2 FLAIR images with post-contrast enhancement needs further evaluation.
A lacunar infarct is appreciated in the left periventricular region.
Left eye globe is shrunken due to previous trauma.
Note is made of bilateral maxillary, ethmoid and sphenoid sinusitis with bilateral mastoiditis and mild deviation of the nasal septum with convexity towards the right side.
Case Discussion
Location of the lesion with the positive dural tail sign is characteristic for planum sphenoidale meningioma.