Diagnosis: Neoplasm of unspecified nature of brainClinical question: h/o right brain tumor; preop planning for resectionSigns and Symptoms: preop planning for resection There is an extra-axial enhancing parafalcine mass measuring 59 x 40 mm axial dimensions which compresses the adjacent right precuneus, right paracentral lobule and right parietal lobe associated with multiple flow voids. It extends to the adjacent superior sagittal sinus were no flow void is appreciated along the length of this extra-axial mass. There is associated signal hyperintensity on T2 imaging within the adjacent white matter compatible with vasogenic edema.There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.Large extra-axial parafalcine mass centered adjacent to the right parietal lobe associated with suspected occlusion or near occlusion of the adjacent superior sagittal sinus most likely represents a meningioma. There is adjacent vasogenic edema and mass effect.2.Please note that this examination is limited for the purposes of stereotactic guidance during surgery.3.Periventricular and subcortical white matter changes of a mild degree are nonspecific. At this age they are most likely vascular related. 