Findings:
There is a well defined, extra-axial, lobulated, heterogenous lesion centered within the left Meckle’s cave, indenting the left cavernous sinus. The lesion is predominantly isointense to hypointense on T1W image and hyperintense on T2 W images and shows prominent heterogenous enhancement on contrast administration. Posteriorly, the lesion extends to the left cerebellopontine angle without any mass effect. It measures approximately 2.5 x 1.8 x 1.8 cm. The left internal carotid artery abuts the lesion medially.
The Circle of Willis is normal with no aneurysm or vascular malformation. The dural venous sinuses are patent.
Multiple FLAIR/T2 hyperintense lesions in the supratentorial white matter, in keeping with mild small vessel ischemia. The brain parenchyma is otherwise unremarkable.
The pituitary gland is normal.
Mild mucosal thickening is seen in both maxillary sinuses. The orbits, the paranasal sinuses and the mastoid air cells are otherwise clear.
No bony abnormality is seen. The craniocervical junction is normal.
Conclusion:
Heterogeneously enhancing mass lesion within the left Meckel’s cave with minimal extension into the left cerebellopontine angle, most likely in keeping with a trigeminal schwannoma.