Demographics:
34 years old, Male
Indication:
Blurry vision
Findings
- Extensive nodular enhancement along the ependymal lining of the atria, occipital horns, and temporal horns of the right greater than left lateral ventricles with involvement of the choroid plexus bilaterally and extensive periventricular T2/FLAIR white matter hyperintensity
- Additional areas of nodular enhancement along the floor of the third ventricle and in the suprasellar cistern involving the optic chiasm and encasing both prechiasmatic optic nerves
- Postbiopsy changes in the left temporal lobe
- No evidence of acute infarct, hemorrhage, mass effect, or hydrocephalus
- Mild mucosal thickening of the bilateral maxillary sinuses
Diagnosis
Neurosarcoidosis
Sample Report
Extensive nodular enhancement along the ependymal lining of the atria, occipital horns, and temporal horns of the right greater than left lateral ventricles with involvement of the choroid plexus bilaterally and extensive periventricular T2/FLAIR white matter hyperintensity. Additional areas of nodular enhancement along the floor of the third ventricle and in the suprasellar cistern involving the optic chiasm and encasing both prechiasmatic optic nerves. Differential considerations for this imaging appearance include basal meningitis (including tuberculosis), sarcoidosis, lymphoma, and less likely metastatic disease.
No evidence of acute infarct, hemorrhage, mass effect, or hydrocephalus
Discussion