Demographics:
60 years old, Female
Indication:
Headache
Findings
- Numerous peripherally enhancing lesions involving the supratentorial and infratentorial brain with the following index lesions: 1.2 cm lesion in the posterior aspect of the left superior frontal gyrus, 1.3 cm cortically-based lesion in the left inferior frontal gyrus, 4 cm lesion in the right cerebellar hemisphere abutting the sigmoid sinus (which remains patent), and 2 cm lesion in the medial left cerebellar hemisphere/vermis
- The cerebellar lesions have surrounding vasogenic edema and mass effect with resultant partial effacement of the fourth ventricle and inferior displacement of the cerebellar tonsils into the foramen magnum with mild crowding of the upper cervical spinal cord in the foramen magnum. Mild enlargement of the lateral and third ventricles
- Mild vasogenic edema and local mass effect associated with several of the supratentorial lesions
- Several lesions have peripheral restricted diffusion, but none of the lesions have central restricted diffusion
- Several lesions demonstrate internal areas of susceptibility artifact
- No evidence of acute infarct
Diagnosis
Brain metastases
Sample Report
Numerous peripherally enhancing lesions involving the supratentorial and infratentorial brain which are most concerning for metastatic disease. Several lesions demonstrate internal areas of susceptibility artifact consistent with intralesional hemorrhage. No associated central restricted diffusion to suggest abscess.
Associated mass effect in the posterior fossa with partial effacement of the fourth ventricle and inferior displacement of the cerebellar tonsils into the foramen magnum with mild crowding of the upper cervical spinal cord in the foramen magnum.
Mild enlargement of the lateral and third ventricles is concerning for mild/early hydrocephalus.
No evidence of acute infarct.
Discussion
References
No references for this case.