Meningiomas are extra-axial tumors with a long-standing indolent clinical course.Sphenoid wing meningiomas may slowly grow, spreading toward the orbitofrontal and temporal regions as well as encasing the middle cerebral artery (MCA). Herein, we report the incidental finding of a sphenoid wing meningioma compressing the MCA in a patient who undergone a transcranial sonography study for recurrent speech disorders. We illustrate the associated sonographic "red flags" which should prompt to suspect an underlying compressive space-occupying lesion. K E Y W O R D S brain neoplasm, intracranial arterial stenosis, meningioma
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