Wk 8, Case 2 - Review

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Report

Patient History
Asymptomatic. Clival lesion seen on post-trauma CT scan.

Findings
The T2 signal of the clivus and the post gadolinium enhanced scans of the clivus are unremarkable other than a small area of high signal intensity on T2-weighted imaging in the midline of the clivus which does not show contrast enhancement. This area on CISS imaging measures 3 mm.

Normal variation bilateral enlargement of the Meckel’s cave region is seen. There is no evidence of hydrocephalus. There is no evidence of mass effect. There is no evidence of midline shift. Diffusion weighted images are similarly unremarkable. There is a partially empty sella present. The enhanced images of the entire brain are unremarkable.

When compared with the prior CT scan, no change has occurred.

Impressions
No evidence of significant mass lesion. The 3 mm area of high signal on T2 weighted scan may be normal variant ecchordosis physaliphora.

Case Discussion

Faculty

David M Yousem, MD, MBA

Professor of Radiology, Vice Chairman and Associate Dean

Johns Hopkins University

Joshua P Nickerson, MD

Associate Professor of Neuroradiology

Oregon Health & Science University

Francis Deng, MD

Assistant Professor of Radiology and Radiological Science

Johns Hopkins University School of Medicine

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Wk 8, Case 2 - Review