Cerebral infarction, unspecified [I63.9], Reason for Study: ^Reason: concern for tumor History: right facial weakness Brain MRIDue to patient motion artifact, especially post contrast scans are nondiagnostic.There is ill defined intra-axial mass involving left frontal lobe, temporal lobe anterior aspect as well as insular cortex with the significant surrounding edema generating mass effect. There is about 7.2 mm midline shift at the level of foramen of Monro.There is no evidence of acute ischemic lesion, however, the mass shows petechial susceptibility artifacts within the lesion indicate hemorrhagic component.Although is nondiagnostic, axial postcontrast enhancement scan shows relatively intense enhancement of the lesion with overlying dural matter.Constellation of above findings indicate possible diagnosis of primary brain tumor such as glioblastoma or metastatic disease.Normal flow voids are identified in the major intracranial vessels. The mastoid air cells are clear.There are opacifications within the left sphenoid sinus and right posterior ethmoid sinus indicate high protein content retention cyst or high protein content fluid collection.Brain MRA 3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate diminutive left MCA distal M2 and M3 segment indicating external compression due to intra axial mass lesion. Otherwise no remarkable finding.No intracranial arterial aneurysm. No intracranial arterial luminal stenosis.
1. Left fronto temporal intracranial mass with surrounding edema and mass effects likely represent malignant lesion such as glioblastoma or metastatic lesion.2. Extrinsic compression toward left MCA M2 and M3 segment as described above, otherwise no remarkable finding on brain MRA. 