Case History: 31-year-old female presents with complaints of headache and tinnitus.
MRI showed a right CP angle mass 20x15-mm low signal on T1W and mildly hyperintense on T2W and flair images.
Figure 1. T2WI showing hyperintense mass in right CP angle.
Figure 2. FLAIR image showing hyperintense mass in right CP angle.
Figure 3. T1W image showing hypointense mass in right CP angle
Figure 4. T1 contrast image showing enhancing mass in right CP angle.
Figure 5. MRS shows elevated CHO/CR ratio with reduced NAA and also alanine peaks.
The cerebellopontine angle (CPA) is a relatively frequent site of intracranial masses, many of which are specific for the region.Â
Characteristics of masses with high T1 signal on MRI and masses with CSF intensity/density.
Characteristics of other masses.
Meningiomas are more common in women, with a ratio of 2:1 intracranially, and 4:1 in the spine.
Meningiomas may become clinically apparent due to complications dependent on location.
Meningiomas demonstrate oestrogen sensitivity and may grow during pregnancy.
Macroscopic and microscopic characteristics.
Atypical meningioma have a greater tendency to recur.
There is also a Simpson grade for meningiomas.
Meningiomas are located anywhere that meninges are found.
Plain films no longer have a role in the diagnosis or management of meningiomas.
As is the case with most other intracranial pathology, MRI is the investigation of choice for the diagnosis and characterization of meningiomas.
Meningiomas typically narrow arteries, which they encase.
Usually MRS does not play a significant role in diagnosis, but can help distinguish meningiomas from mimics.
Treatment is usually with surgical excision.
Possible differential diagnoses.
