Case Challenge

Brain

Neuro

Stephen J Pomeranz

Gain confidence interpreting Brain MRI w/ practice cases from MRI Online. Quiz yourself using real-world, interactive scrollable cases & earn CME. Try it free!

Case Review

Neuroradiology

Post-Course Activities

This Power Pack is comprised of 35 unique Brain MRI cases that you can scroll through in our diagnostic web viewer to determine your findings. Quiz yourself and earn CME.

Brain MRI Cases

Case 24 - 59-year-old female presents with blurred vision

<div>HISTORY:&#160;This 59-year-old female presents with blurred vision, and headaches for six months.(QUIZ ANSWER) NOT A LIKELY DIFFERENTIAL:&#160;Benign meningioma.Using the diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.FINDINGS: 10 x 3.2 x 6.5cm left calvarial, extracalvarial and intracranial extraaxial mass with mass effect upon the left frontal lobe which extends near to the midline without underlying acute edema.&#160;There is effacement of the left lateral ventricle.&#160;Hyperintensity on T2 within the left temporal horn may represent a neuroepithelial cyst.&#160;There is temporal horn enlargement on the right which may represent early hydrocephalus.&#160;The adenoids are prominent.&#160;Craniocervical junction is without Chiari malformation.&#160;Subcortical hyperintensities may represent gliosis of microangiopathic origin. The lesion appears to be extraaxial. There is mild shift of the midline of approximately 5mm.&#160;Seventh and eighth nerve complexes are intact. Cochleae and vestibula are intact. Otomastoid airspaces are clear.&#160;The sagittal sinus signal is attenuated, but flow may be preserved.&#160;CONCLUSION:&#160;1. Large left extraaxial mass with subdural calvarial and extracalvarial components and mass effect upon the left frontal lobe without acute edema or hemorrhage. 5mm of midline shift and left ventricular effacement. Differential may include lymphoma, malignant meningioma, hemangiopericytoma, melanoma.&#160;2. Prominent adenoids may be supportive of lymphoproliferative etiology.&#160;3. Temporal horn dilatation on the right may be suggestive of early hydrocephalus.</div>

Case

Which of the following is NOT a likely differential in this case?