Meningioma - Jugular Foramen

•  Arises from arachnoid cap cells found along the cranial nerves which pass through the jugular foramen
•  Look for permeative-sclerotic bony erosions on CT and tumor spread along dural surfaces on post-contrast T1 MR
•  Typically large at presentation (>3 cm) with poorly-defined margins and centrifugal spread, especially along dura
•  On CT: hyperdense mass with permeative-sclerotic bony changes without contrast, high density with contrast
•  CT spread patterns:
  •  Superolateral to middle-ear mastoid space
  •  Lateral to CN VII mastoid segment
  •  Anterior to horizontal petrous ICA canal
  •  Anteromedial to patrous apex
• On MR:
  •  Hypo- to isointense on T1 with ABSENT flow voids and rarely bright calcifactions
  •  Hypointense on T2
  •  FLAIR hyperintense,
  •  T1 post-contrast is hyperintese with good definition of spread
•  Most common in 40-60 year-olds with a male to female ratio of 1:2