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Case #19

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Demographics: 26 years old, Male
Indication: Seizure

Findings

  • 9 mm round peripherally enhancing, T2/FLAIR hyperintense lesion in the subcortical white matter of the right superior frontal gyrus with surrounding T2/FLAIR white matter hyperintensity
  • Trace associated susceptibility artifact
  • Mild associated local mass effect without midline shift or herniation
  • Additional 9 mm T2 hyperintense, FLAIR hypointense lesions with faint peripheral enhancement in the superior aspect of the right hippocampus without surrounding T2/FLAIR hyperintensity
  • No evidence of acute infarct, hemorrhage, or hydrocephalus
  • T2 hyperintense foci in the bilateral basal ganglia with signal suppression on FLAIR, favored to represent dilated perivascular spaces
  • Small developmental venous anomaly in the right centrum semiovale
  • Polypoid mucosal thickening of both maxillary sinuses with mild mucosal thickening of bilateral ethmoid air cells

Diagnosis

Neurocysticercosis

Sample Report

9 mm peripherally enhancing cystic lesion in the right superior frontal gyrus with surrounding edema, favored to represent neurocysticercosis in the colloidal vesicular stage.

No associated restricted diffusion to suggest abscess. Mild local mass effect without midline shift or herniation.

Additional 9 mm peripherally enhancing cystic lesion along the superior aspect of the right hippocampus may represent a neurocysticercosis lesion in the granular nodular stage versus a choroidal fissure cyst with enhancing choroid.

No evidence of acute infarct, hemorrhage, or hydrocephalus.

Discussion

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