PMC3364100_01
Coronal T1-weighted contrast-enhanced MR images. a Image obtained 4 months prior to admission shows an avidly enhancing extra-axial left cerebellar mass. b Image obtained shortly after admission shows dramatic growth of the left cerebellar mass. c Same study as in b; this image shows an additional small nodular extra-axial mass of similar contrast enhancement to the primary lesion (arrow).
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Then, 4 months prior to this admission, the patient had experienced progressive ataxia and lower extremity paresthesias eventually leading to a brain MRI which showed an avidly enhancing extra-axial left cerebellar mass (fig. 1a) most consistent with benign meningioma. Repeat MRI at this time showed that the cerebellar mass had expanded over a period of 4 months from 1.6 x 1.6 x 1.5 cm to 4.8 x 4.4 x 4.0 cm with effacement of the 4th ventricle, obstructive hydrocephalus, and additional small foci of similar enhancement located extra-axially at distant but still intracranial sites (fig. 1b, c).