CPA meningioma

Case contribution: Dr Radhiana Hassan


  • A 48 years old female
  • Presented with dizziness and vertigo, no tinnitus, no hearing disturbance
  • No loss of consciousness, no seizure, no headache or blurred vision
  • Clinically cranial nerves are intact. No nystagmus.

MRI findings:

  • There is an extra-axial mass lesion at left cerebello-pontine angle (Yellow arrows)
  • This lesion is isointense on T1, hyperintense on T2, not suppressed on FLAIR and shows homogenous enhancement post contrast
  • There is no blooming artefact on GRE and no restricted diffusion (images not shown)
  • broad based attachment to the dura is also seen.
  • Extension and causing widening at the opening of the adjacent internal auditory
  • However the vestibulocochlear nerves are seen not enhanced (red arrows)
  • No bone erosion or hyperostosis (ct images not shown)

Diagnosis: CPA meningioma


  • CPA dural-based enhancing mass with dural tail sign (60% of cases)
  • On T1, iso to minimally hyperintense to gray matter
  • On T2Wi wide range of possible signal
  • Calcification may bloom on GRE
  • 95% enhances strongly, heterogenous enhancement if large lesion
  • when extending into IAC may mimic vestibular schwannoma as in this case
Author: radhianahassan