Jugular Tubercle Meningioma with Hemorrhagic Conversion Mimicking a Ruptured Thrombosed Giant Vertebrobasilar Aneurysm

Hemorrhagic meningiomas can have a clinical and radiologic picture that closely resembles a ruptured, thrombosed cerebral aneurysm. Based on our single case, we suggest several important diagnostic differentiators between these 2 entities. We found the hemorrhagic meningioma to exhibit eggshell-like rim calcification, thick, irregular peripheral enhancement, and a central cystic component. This can be contrasted to the classic appearance of a thrombosed aneurysm with mixed T1-, T2-weighted signal intensity, and occasional regular, thin peripheral enhancement.