| The most likely mechanism is direct extension to the skull base with involvement of the petrous apex and further extension posteriorly via the medial tentorial edge. |
| Cranial MRI showed a bilateral subacute subdural hematoma in the frontotemporoparietal region and subacute hemorrhage in the right tentorial region. |
| A computed tomography scan of the brain showed diffuse cerebral edema with tentorial herniation. |
| There was smooth enhancement of dura along the sphenoid wing, right tentorial incisura and clivus. |
| On referral to our endocrine center, imaging of her pituitary revealed no evidence of a prolactinoma, although a small incidental tentorial meningioma was seen. |
