CASE REPORT
21y.o. female presented with progressing stabbing headaches of three weeks, nausea, and vomiting. Her medical history and physical and neurological exams were unremarkable. Infused CT revealed a homogeneous enhancing lesion in the left middle cranial fossa. The greater sphenoid wing looked remodeled (Fig 1).
An enhanced MRI showed well-demarcated margins of the lesion and dural tail sign (Fig 2). Angiography revealed hypervascular lobulated tumoural blush, and persistent staining. The main arterial supply was arising from enlarged middle meningeal and accessory meningeal branches (Fig 3).
After successful endovascular embolization the tumour was completely resected surgically. Histopathology showed a capillary hemangioma.
DISCUSSION
Capillary hemangiomas (CH) are frequent tumours in children and in 50% of the cases affect the head and neck. The CNS is a rare location for these tumours, and most cases reported involve the spinal cord of adults.² The descriptions of isolated intracranial CH are scarce. They may involve the brain parenchyma or the dura. Our case adds to the short list of intracranial dural CH. The CT and MRI features in dural CH are similar to those of meningioma, and the literature does not seem to identify characteristics that would allow imaging differentiation between these lesions. In our patient the presence of a dural tail favored meningioma, however, the bone remodeling and the angiographic appearance (Figs. 1,3) lead us to consider hemangiopericytomas, hemangiomas, and angiosarcomas in the differential diagnosis. Histopathology confirmed the diagnosis of CH.^1,2,3 (Photomicrograph Fig 4)

CONCLUSION
Intracranial dural capillary hemangioma is rare. Its radiological appearance may be misleading due to the resemblance to meningioma. Careful correlation of CT, MRI, and Angiography may provide clues to the presence of hypervascular tumours, among them, capillary hemangioma.

REFERENCES