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Author Archives: Asim Bag
Aunt Mickey (They Look the Same until You Undress Them). Posterior Fossa Tumor or Something Else?
51-year-old male with no significant past medical history presented with 3+ months H/O intermittent dizziness, intermittent headaches, difficulty going down stairs and 3+ days H/O tingling and numbness on the right side of face, right hand and foot. MRI revealed increased T2 signal and swelling of the entire pons including the middle cerebellar peduncles with effacement/obliteration of the prepontine and CP angle cisterns. Center of the lesion was heterogeneously T2 hypointense and showed heterogeneous contrast enhancement, small focus of diffusion restriction, focal area of increased CBV and high choline to creatine ratio (2.18) & a tall lactate peak on MR … Continue reading >>
Posted in Aunt Mickeys, Brain
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Aunt Mickey (They Look the Same until You Undress Them). Meningioma or Something Else?
73 year old lady presented with six weeks history of odd behavior, increasing apathy, expressive aphasia, and mild headache. An MRI including diffusion and perfusion imaging was obtained. MRI revealed a T1 hypointense (to cortex) and slightly T2 hyperintense (to cortex) extra-axial mass in the left frontal region. There were multiple central T2 hyperintense areas. On post contrast T1 weighted sequence, there was intense enhancement of the mass except the central T2 hyperintense areas.There were prominent diffusion restriction and high rCBV in most parts of the tumor in diffusion and perfusion imaging respectively.
At this point, what is your diagnosis? … Continue reading >>
Posted in Aunt Mickeys, Brain
Tagged Diffusion imaging, meningioma, Perfusion imaging, Primary CNS lymphoma
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Aunt Mickey (They Look the Same until You Undress Them). Meningioma or Something Else?
51 year old lady presented with headache and gait disturbances. An MRI including perfusion imaging was obtained. MRI revealed an extra-axial, dural based mass of the posterior fossa which was isointense to gray matter on T1 weighted sequence and hyperintense to gray matter on T2 weighted sequence. There was no diffusion restriction. On T2 weighted sequence, there was wedge shaped area of perilesional T2 hyperintensity extending transversely and superiorly to involve vermis. With contrast, the lesion showed intense homogenous enhancement. On perfusion study, there was considerable increase in rCBV. Preoperatively it was diagnosed as meningioma and the patient was scheduled … Continue reading >>