PMC3299556_01
Noncontrast axial computed tomographic image initially identifying a giant, approximately 10 cm hyperdense partially calcified mass encompassing the entire frontal lobe.
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An emergent noncontrast computerized tomography (CT) image of the head and orbits (Figure 1) revealed a 10.0 x 7.1 cm hyperdense partially calcified mass extending from the planum sphenoidale to the midfrontal convexity with signs of bilateral optic nerve compression.
Contrast-enhanced T1 axial (A) and noncontrast T1 fat-suppressed coronal (B) magnetic resonance image revealing a large avidly enhancing midline extra-axial mass within the frontal region compressing the region of the optic chiasm and bilateral intracranial optic nerves.
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Magnetic resonance imaging with and without intravenous gadolinium of the brain and orbits (Figure 2A and B) further delineated the CT findings and highlighted a large avidly enhancing midline extra-axial mass within the frontal region measuring approximately 9.4 cm x 6.9 cm in axial dimension, consistent with a meningioma.
Contrast-enhanced T1 axial (A) and sagittal (B) magnetic resonance image 1 week after bilateral frontal lobe craniotomy showing an extensive fluid and extraaxial pneumocephalus in the surgical bed without evidence of residual tumor.
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Postoperative magnetic resonance imaging of the brain with intravenous gadolinium (Figure 3A and B) showed a postoperative cavity with extensive fluid and extra-axial pneumocephalus in the surgical bed, without evidence of residual tumor.