85-year-old woman with history of left lateral C1 fracture and right frontal brain mass diagnosed on outside CT. On the surface of the anterior right frontal lobe, there is a 34 x 31 x 25 mm (2001/20). It is unclear whether this mass is intra-axial or extra-axial with intraparenchymal invasion, however there is thickening of the adjacent dura. Additionally, there are curvilinear areas of calcification along the peripheral, posterior aspect of this mass, better characterized on the CT. This mass is isointense on T1 and slightly hyperintense on T2 weighted images with homogenous, avid enhancement. There is significant amount of abnormal T2/FLAIR signal in the underlying right frontal lobe white matter which extends through the genu of the corpus callosum into the medial left frontal lobe. There is local mass effect on the frontal horn of the right lateral ventricle, 9 mm of leftward midline shift, and slight asymmetric dilation of the left lateral ventricle suggesting entrapment. There is no restricted diffusion to suggest acute ischemia. There is no intracranial hemorrhage. A few additional foci of T2/FLAIR hyperintensity in the bilateral subcortical and periventricular white matter are nonspecific, but compatible with chronic small vessel ischemic changes. The major flow-voids are preserved.The patient is status post right cataract surgery, otherwise the sella and orbits are grossly within normal limits. Paranasal sinuses and mastoid cells are clear. Bone marrow signal and extracranial soft tissues are within normal limits including the calvarium overlying the aforementioned mass. CERVICAL SPINE
1.Avidly enhance mass along the surface of the right anterior frontal lobe with peripheral calcification. While it is unclear whether this mass is intra or extra-axial, differentials include meningioma with invasion of the underlying parenchyma, a solitary dural based metastasis, or a primary glial neoplasm.2.Significant underlying vasogenic edema with midline shift and an asymmetric left lateral ventriculomegaly suggestive of entrapment.3.C1 fracture better characterized on recent CT.4.Edema in the interspinous cervical soft tissues which may indicate interspinous ligamentous injury, but no frank disruption of the major cervical ligaments is seen. No cord signal abnormality or epidural hematoma.5.Multilevel cervical degenerative disc disease with mild to moderate spinal canal stenosis and neural foraminal stenosis.