Left CP angle meningioma (MR).

PROTOCOL:
T1&T2W – Sagittal scans
T1 , T2 & FLAIR W– Coronal images
T1 ,T2FFE (Gradient) & FLAIR– Axial scans
3D TOF MR angiography of the circle of Willis vessels and MIP reconstruction.

FINDINGS:
A well defined mass lesion is seen in the left cerebellopontine angle of intermediate SI on T1 and high SI on T2 and FLAIR WI  measuring about 27 x 18 x 23 mm in AP x TS x CC dimensions compressing the lateral aspect of the pons and middle cerebellar peduncle.  The mass is extending into the meckels cave although not reaching upto the cavernous sinus. This mass lesion exhibits homogenous enhancement after IV contrast injection. There is also a dural tail sign seen in the region of the tentorium.
Mega cistern magna is noted (Normal variant).
Otherwise brain Parenchyma shows normal grey white matter differentiation and signal intensities.
Lateral and third ventricles are normal in size and position.  There is no midline shift.

Basal cisterns, cortical sulci and gyri are normal in appearance.

Fourth ventricle is normal in size and is midline in position.

MR angiography reveals normal course, caliber and outlines of vessels of bilateral CA, ACA, MCA, PCA and their peripheral branches. Vertebro basilar trunk is also normal in appearance.

OPINION:

• Extra axial Left CP angle mass lesion with MRI feature as described above and extending into the meckels cave with obliteration of the left trigeminal nerve; 
• Possiblities:1. Left sided Trigeminal schwannoma . 2. Meningioma 
•  Note is made of left maxillary sinusitis.

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