Presentation
Headaches and vertigo.
Patient Data
Small extra-axial dural-based lesion at the left cerebellopontine angle, extending into the IAC. It appears isointense to the cortical grey matter on both T1 and T2, hyperintense on FLAIR With intense and homogeneous enhancement on postcontrast sequences with a dural tail sign. No calcification or hemorrhagic component is seen on the T2* sequence.
Case Discussion
The MRI features are most consistent with a CPA meningioma. The main differential diagnosis is the acoustic schwannoma, which appears more rounded, and has a high signal on T2 with central cystic/hemorrhagic changes and no dural tail sign.