Intraparenchymal Meningioma: A Diagnostic Dilemma

A 25 year old man presented with an intraparenchymal meningioma, without any dural attachment, manifested as repeated attacks of seizures preceded by aura and left side hemicranial headache for 3 months. Neurological examination showed no abnormalities on admission. MR images show a left frontal intraparenchymal solid well circumscribed space-occupying lesion. The tumor was iso-intense on T1-weighted image and heterogeneously iso to hyperintense on T2-weighted images. Enhances brilliantly and homogeneously with gadolinium contrast. The mass was associated with minimal perilesional edema. No dural attachment observed or any dural enhancement on contrast imaging (dural tail sign absent). Total surgical resection of the tumor was done. Histopathological examination revealed meningioma. Intraparenchymal meningioma should be kept in mind as differential diagnosis of such lesion. ABSTRACT