Presentation
Occasional headaches
Patient Data
There is an extra-axial lesion inferobasal on the left, of some 9 x 7 x 8 mm in size, which is slightly hyperintense in T2 and especially on FLAIR, with strong, homogeneous signal intensity enhancement after contrast administration. It demonstrates a characteristic "dural tail sign" (best seen on sagittal projection), which is consistent with a meningioma.
There is also another lesion, demonstrating a characteristic “popcorn” or "berry" appearance with a rim of signal loss due to hemosiderin, with some patchy signal intensity enhancement after contrast administration, which is suggestive of a cavernous hemangioma.
Case Discussion
The patient complained of the occasional headaches for several months.
Neurologic examination was unremarkable.
Cavernomas are usually asymptomatic, so the meningioma could be responsible for her headaches, but since she is on antihypertensive therapy for a long time, and also has a few punctiform ischemic lesions, we can not be certain about the cause of her problems.
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