0:01

Patients with masses in their brain will

0:05

also present with new neurologic deficits,

0:08

and/or headaches, and/or seizure disorders.

0:13

This was a patient who presented as

0:15

an individual with a new hemiparesis.

0:19

As you can see, there is this mass, which is located

0:23

in the medial right frontal and parietal lobe,

0:28

spanning the expected location of the motor strip.

0:33

If we look on our diffusion-weighted imaging, B0, and

0:37

then our B1000, we do not see bright signal intensity,

0:41

and therefore, we conclude this is not due to a stroke.

0:44

What we are seeing with this very dark

0:46

signal intensity is hemorrhage in the brain.

0:50

And if we were to proceed with our susceptibility

0:54

weighted scan, we would identify that

0:57

this was indeed a hemorrhagic lesion.

1:00

Here's the T2-weighted scan, which is also demonstrable

1:05

for the presence of the hemorrhage within this

1:08

mass, represented by the dark signal intensity.

1:12

This dark signal intensity is deoxyhemoglobin.

1:16

On the post-contrast scan, when we get up to the

1:20

lesion, we see that there is peripheral enhancement

1:24

in this lesion, as well as solid enhancing portions.

1:29

This mass abuts on the falx, posteriorly,

1:35

and therefore, you might wonder, is

1:37

this an intraaxial or extraaxial lesion?

1:41

And the coronal doesn't help us all that much,

1:45

because there's both a portion that's abutting on

1:47

the falx as well as projecting into the parenchyma.

1:51

This patient went to surgery.

1:54

This was a glioblastoma.

1:56

A high-grade astrocytoma that had infiltrated to

2:02

the surface of the brain and even to the falx.

2:06

So, brain tumors, be it metastases or

2:10

be it primary brain tumors, may also

2:13

present with a new neurologic deficit.

Case: Glioblastoma

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