Female, 59 years old, with headache and back pain, history of spinal tumor, concern for mass recurrence. A uniformly enhancing plaque-like dural/epidural mass is evident extending along the clivus to the craniocervical junction. A small tail of this lesion also extends laterally along the skull base towards the left jugular foramen. This lesion measures up to 48 x 13 mm in the sagittal plane with encroachment upon the prepontine cistern, displacement of the vertebral arteries, and mild deformity of the brainstem. No outside examinations are available at the time of this interpretation for comparison purposes.No evidence of parenchymal edema is seen. Numerous scattered foci of white matter T2 hyperintensity are evident in the bilateral cerebral hemispheres, a nonspecific finding which may reflect chronic microvascular ischemic disease. No evidence of diffusion restriction is seen.No other areas of pathologic parenchymal or extra-axial enhancement is seen. No intracranial hemorrhage or any abnormal extra-axial fluid collection is detected. The ventricular system is patent and normal in size.
1.A dural/epidural plaque-like mass is evident extending along the clivus down to the level of the craniocervical junction, and laterally towards the left jugular foramen. This lesion effaces the prepontine cistern and causes mild mass effect upon the adjacent brainstem, but no evidence of parenchymal invasion or parenchymal edema is seen.2.No outside examinations are available at the time of this interpretation for comparison purposes. If these can be made available, comparison will be made and an addended report will be generated.3. No other significant intracranial lesions are seen. Findings are noted likely related to chronic microvascular ischemic disease.