Preoperative planning for a brain tumor. Altered mental status. There is an enhancing bithalamic mass with extension into the posterior basal ganglia on the left side, which measures up to 36 mm. There is diffuse T2 hyperintensity in the right limbic system distribution and in the posterior corpus callosum. There is also a T2 hyperintense left medial temporal lesion and a punctate focus of encephalomalacia in the right caudate nucleus. There is effacement of the third ventricle and dilatation of the bilateral lateral ventricles. There is no midline shift or herniation. There are skin fiducial markers.
1. Preoperative planing MRI for a bithalamic mass that likely represents a high-grade glioma with associated obstructive hydrocephalus. Abnormality in the right limbic system distribution and posterior corpus callosum may be related to seizure activity and/or non-enhancing tumor infiltration, but is incompletely assessed on these limited surgical planning images. 2. Unchanged left medial temporal lesion. 3. Chronic punctate lacunar infarct in the right caudate nucleus.