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MRI of the brain demonstrates a large left sided extra-axial posterior fossa mass. It is isointense to the cerebellum on T1 weighted images, and hyperintense on T2. Following contrast administration it vividly and homogeneously enhances. There is no evidence of calcification or haemorrhage, however it does modestly restrict on DWI.
The mass invades and occludes the transverse and proximal sigmoid sinus as well as invades into the skull, with a single nodular focus passing through the outer table and into the subcutaneous tissues of the scalp. It also extends superiorly through the tentorium into the supratentorial compartement.
The cerebellum is markedly distorted by the mass and has oedema within it. Somewhat surprisingly there is no hydrocephalus despite effacement of the fourth ventricle.