A 20 year female patient with 6th cranial nerve palsy on T2 weighted MRI shows a hyperintense lesion in cavernous sinus which shows homogenous contrast enhancement. Most probable diagnosis is?

Some guides have given schwannoma as the answer. They are wrong. Intense homogenous contrast enhancement is characteristic of meningioma. "Meningioma usually have similar characteristics to schwannomas, being isointense on T1 image and hyperintense on T2 weighted image. However; Homogeneous and significant contrast enhancement is a characteristic appearance of meningioma". Schwannomas show Heterogeneous (non-homogenous) and moderate contrast enhancement. Regarding 6th nerve palsy:- "Cavernous sinus (paracellular) meningiomas present with retro-orbital pain and sixth cranial nerve palsy". — Tumor neurosurgery: principles & practice. About option b & d Optic nerve glioma (Astrocytoma) is seen in children (first decade) Cavernous hemangioma also shows homogenous contrast enhancement but it is a moderate enhancement (not intense). Further cavernous hemangioma does not cause 6th nerve palsy.