case_images: PMC3680997_01
case_images: Top row: Coronal and axial CT of the head reveal an expansile lesion expanding the roof of the left optic canal and opacifying the left ACP. Of note, the right ACP is aerated. Row 2: Axial MRI of the brain demonstrates a lesion adjacent to the left ACP. T1-weighted fast spin echo sequences with and without gadolinium show no discernable contrast enhancement. Suppression of fat attenuation showed no changes in the appearance of the hyperintense lesion (not depicted). Rows 3 and 4: Coronal and sagittal T2-weighted and steady-state free precession sequences show mass effect upon the left optic nerve at the level of the orbital apex, and upon the anterolateral aspect of the left cavernous sinus
case_images: SNI-4-63-g001.jpg
case_images: PMC3680997_01_SNI-4-63-g001.jpg
case_images: F1
case_images: Computed tomography (CT) and magnetic resonance imaging (MRI) were obtained [Figure 1], and the patient was referred for neurosurgical evaluation.
case_images: Top row: Axial T1- and T2-weighted MRIs of brain demonstrate removal of the lesion adjacent to left ACP. The left optic nerve is visible and well-decompressed. Bottom row: Coronal postgadolinium T1-weighted MRIs show resolution of mass effect upon left optic nerve at the orbital apex and cavernous sinus
case_images: SNI-4-63-g002.jpg
case_images: PMC3680997_01_SNI-4-63-g002.jpg
case_images: F2
case_images: The superior orbital fissure and optic canal were confirmed to be well-decompressed, and the point of communication into the sphenoid sinus was sealed with a pericranial graft and fibrin glue [Figure 2].