Presentation
Headache, neck pain.
Patient Data
A well-defined dural-based space-occupying lesion is noted lying on the posterior aspect of the foramen magnum and the posterior neural arch of atlas with no bony invasion. It is opposite to and compressing the cervico-medullary junction of the spinal cord and displacing it to the anterolateral aspect of the foramen magnum. It displays iso-intense signal in T1 WI and hypo-intense signal in T2 WI. It showed homogeneous enhancement in contrast-enhanced T1WI.
Case Discussion
For a dural-based homogeneously enhancing lesion, meningioma is the most likely differential and the foramen magnum is one of its recognized, albeit less common, sites.