Presentation
Seizures.
Patient Data
There is a well-circumscribed left frontoparietal broad-based extra-axial mass with " CSF cleft sign" and adjacent reactive hyperostosis. It displays a low signal on T1, iso-to low signal on FLAIR and T2 with central hypointense areas (probably calcification), and surrounding vasogenic edema. The postcontrast sequences show a vivid heterogeneous enhancement with a "dural tail sign" as well as an extension into the adjacent hyperostosis. A mass effect is noted on the midline structures with subfalcine, and downward transtentorial herniations (uncal, and central).
Case Discussion
MRI features most consistent with a supratentorial meningioma which is considered the most common location (85-90%) with subfalcine and downward transtentorial herniations.
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