46 year old presented with left hearing loss and multiple cranial nerve abnormalities on the left

IMG 1 of 2

IMG 2 of 2

Dx= cerebellopontine angle meningioma
Ddx for CPA masses =

• acoustic schwannoma,
• epidermoid,
• trigeminal schwannoma,
• exophytic brain stem glioma,
• metastasis,
• cholesteatoma (acquired),
• cholesterol granuloma,
• arachnoid cyst,
• aneurysm,
• vertebrobasilar dolichoectasia

IMG 1 of 2
T1-weighted coronal images after the intravenous administration of gadolinium-DTPA demonstrate intense homogeneous enhancement, with better visualization of the full extent of this very large mass. Note also that the 7th and 8th nerve complex in the internal auditory canal can be identified, and that no enhancing mass is seen within the canal

IMG 2 of 2
Selected images from a preoperative angiogram with injection of the left external carotid artery demonstrates that the tumor is supplied by multiple branches of the external carotid artery and has a vascular pattern which is characteristic of the final pathologic diagnosis.