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FIG 1. Patient 3, a 78-year-old man status post prior resection of a desmoplastic melanoma of the left forehead presents with numbness over left forehead and diplopia.
A, Contrast-enhanced axial T1-weighted image (600/11/2 [TR/TE/NEX]) with fat saturation demonstrates abnormal enhancement in the left CN III (arrows) and cavernous sinus. There is also enhancement in the left temporalis muscle secondary to denervation change.
B, Contrast-enhanced coronal T1-weighted image (600/11/2) with fat saturation demonstrates abnormal soft tissue prominence and enhancement at the level of the left frontal nerve (arrow). Increased signal intensity of the left temporalis muscle is consistent with denervation change. In addition, a small left subdural hematoma (arrowheads) is incidentally noted in this elderly patient. This demonstrated intrinsic T1 shortening consistent with blood products and resolved on a follow-up scan (not shown).
C, A more posterior contrast-enhanced coronal T1-weighted image (600/11/2) with fat saturation demonstrates enhancing soft tissue in Meckel’s cave on the left (lower arrow), consistent with involvement of the gasserian ganglion, as well as abnormal enhancement and enlargement of the left CN III (upper arrow) and abnormal enhancement and enlargement of the left CN VI (arrowhead) as well.
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