We describe a 35-year-old man with a history of remote closed head injury w
ho presented with new neurologic deficits. A noncontrast head CT scan showe
d hyperattenuation involving both temporal lobes, frontal lobes, basal meni
nges, and cerebellum. A subsequent contrast-enhanced MR examination of the
brain showed enhancement in the basal cisterns extending into the upper cer
vical spine and throughout the spinal canal. Gross, histologic, and immunoh
istochemical analysis revealed meningeal melanocytoma.