EC Neurology

A 69-year-old woman presented with a 9-month history of progressive facial numbness in the distribution of the left mandibular nerve and left facial palsy. Magnetic resonance imaging (MRI) revealed a lesion of left Meckel’s cave, isointense compared with surrounding brain on T2 weighted-imaging and Fiesta sequence (Figure 1A and 1B) and shows avid enhancement after gadolinium administration (Figure 1C), consistent with a Meckel's cave meningioma, Grade IV of Samii classification.

Meningiomas in Meckel's cave are uncommon and often involve the trigeminal nerve and the dura of the petrous apex. Although they are typically isointense or hypointense on T1-weighted images and hyperintense on T2-weighted images, the lesion may occasionally appear with mixed solid-cystic or predominantly cystic components on imaging.

1. Chen X., et al. “Radiological features of Meckel's cave meningiomas”. Journal of Clinical Neuroscience3 (2012): 414-418.
2. Lee JW., et al. “Radiologic findings of Meckel's cave meningiomas: report of six cases”. Journal of Korean Neurosurgical Society1 (2010): 21-25.
3. Liu A., et al. “Radiological features and pathological findings of Meckel's cave meningiomas”. Journal of International Medical Research11 (2018): 4617-4626.