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