Headache and dizziness with history of likely metastatic renal cell to the brain. There is an approximately 3.0 x 3.0 x 2.0 cm (AP by transverse by CC) heterogeneously enhancing extra axial mass abutting the dural wall of the right cavernous sinus, the anterior clinoid process, and the sphenoid wing. There is associated mass effect and edema involving the right mesial temporal lobe. Additionally, there is hemorrhage extending posteriorly within the right mesial temporal lobe with trace extension of hemorrhage into the temporal horn of the right lateral ventricle and a small amount of hemorrhage layering dependently within the occipital horn. The right M1 segment appears compressed by the lesion but not necessarily invaded or encased. The right A1 segment is not visualized, possibly hypoplastic. No additional enhancing lesions are identified. There is no evidence for hydrocephalus.
Limited stealth MRI demonstrates an approximately 3 cm extra-axial mass abutting the right sphenoid wing and dural wall of the right cavernous sinus. There appears to be associated hemorrhage involving the mesial right temporal lobe with a small amount of hemorrhage extending into the temporal horn of the right lateral ventricle.