Clinical question: Lesion causing seizure? Signs and symptoms: First time generalized seizure. Pre-and post-enhanced brain MRI:Examination demonstrates a well demarcated T1 hypointense and T2/T2 flair hyperintense superficially located nonenhancing intraparenchymal mass in the left superior frontal gyrus with evidence of exophytic growth. There is questionable minimal associated edema. The lesion measures approximately at 19 x 23 x 22-mm in size. There is resultant subtle effacement of the adjacent cortical sulci.There is mild prominence of cortical sulci of the parietal and frontal lobes. The anatomical morphology as well as the signal intensity of brain parenchyma otherwise remains within normal on all MRI sequences. There is no detectable abnormal parenchymal or leptomeningeal enhancement.The signal void of major intracranial arterial branches are identified.There is anatomical variation of partially empty sella of no clinical significance. Unremarkable calvarium and orbits without evidence of abnormal enhancement.All paranasal sinuses and bilateral mastoid air cells and middle ear cavities remain well pneumatized.
1.Well demarcated nonenhancing left superior frontal gyrus tumor (19 x 23 x 22 mm) with minimal surrounding edema and mass effect and with evidence of exophytic growth concerning for a low-grade tumor.2.Unremarkable pre-and post enhanced brain MRI otherwise.