Paralysis agitans: preoperative planning. There is a 1 cm wide enhancing extra-axial mass overlying the left anterior frontal lobe convexity. There is narrowing and blurring of the pars compacta of the substantia nigra which also loses its expected T2 hyperintensity. There is mild diffuse cerebral volume loss and scattered nonspecific foci of T2 hyperintensity. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, and scalp soft tissues are grossly unremarkable. There is scattered paranasal sinus mucosal thickening.
1. Preoperative planning MRI demonstrates substantia nigra changes compatible with Parkinson's disease.2. An extra-axial left frontal convexity mass likely represents a meningioma.3. Scattered nonspecific foci of T2 hyperintensity may represent chronic small vessel ischemic disease. 