Case 311

 A sixty-five-year-old female presented in our hospital for diplopia. Eye sights were getting worse from the previous five months before. She could watch smartphone clearly, but not clearly things far from eyes. She exchanged her glasses twice lately. Her blurred vision worsened further from a week before, unable to drive a car because of one car seemingly such lining two cars side by side. Furthermore, she experienced headache from two months before, being severe at sunset. Medical findings revealed that positive diplopia of all directions, no orbit bruit and no exophthalmos. She experienced left-sided tinnitus for two weeks which disappeared gradually. She took brain MRI for further investigation (Figs 1 - 3).

What is your imaging diagnosis ?

1.　Carotid-cavernous fistula

2.　Epidermoid cyst

3.　Meningioma

4.　Clivus chordoma

5.　Neurinoma

answer

2023.9.22