Clinical question: Evaluate brain lesion. Signs and symptoms: 49-year-old female with brain lesion and edema seen on head CT. Pre and post enhanced brain MRI:Negative diffusion weighted series.Examination demonstrates a well-demarcated hemorrhagic enhancing tumor along the medial aspect of the right high convexity frontal lobe. The tumor measures approximately 20 x 15 x 20 mm and demonstrate fairly extensive surrounding vasogenic edema with resultant leftward deviation of midline of approximately 6 mm. There is no evidence of ventriculomegaly and CSF cisterns remain widely patent.The signal intensity of brain parenchyma is otherwise within normal on all MRI sequences and without detectable abnormal parenchymal or meningeal enhancement.Unremarkable images through the orbits including axial fat sat postcontrast enhanced series.Unremarkable calvarium, paranasal sinuses and mastoid air cells.
1.Single hemorrhagic enhancing mass in the right frontal lobe (20 x 15 x 20 mm) with surrounding vasogenic edema and resultant 6 mm midline shift. Differentials of a cavernoma or less likely a hemorrhagic metastatic tumor should be considered.2.Unremarkable pre and post enhanced brain MRI otherwise.