Benign enhancing foramen magnum lesion

Case contributed by Laurens De Cocker
Diagnosis almost certain

Presentation

Right facial pain for investigation.

Patient Data

Age: 90 years
Gender: Female

An incidental enhancing lesion is found on contrast-enhanced 3D-T1 within the foramen magnum on the left, just behind the vertebral artery. The lesion is hyperintense on 3D-FLAIR. The lesion is isointense to CSF on T2 and T1 without gadolinium.

Case Discussion

Presence of an incidental finding in the foramen magnum on the left on 3D-FLAIR and 3D-T1 post-gadolinium on 3T MRI. The lesion is occult on T2 and T1 before contrast administration. The signal intensities, enhancement and location behind the vertebral artery in the foramen magnum are typical for a benign enhancing foramen magnum lesion.

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