Clinical question:? Intracranial hemorrhage. Signs and symptoms: Seizures. CT of brain without infusion:Large area of vasogenic edema is noted in the right frontal lobe causing significant effacement of adjacent cortical sulci. A subtle mass effect on the right lateral ventricle. Within the area of vasogenic edema a partially cystic and partially solid mass is present. The larger cystic component of the mass measures 28 mm x 32-mm in transaxial dimensions (axial image 14. This finding is highly suspect of a neoplasm. There is no evidence of hemorrhage associated with this finding. There is a single small focus of low attenuation in the subcortical white matter of left posterior frontal (axial image 18). This finding is nonspecific and may represent an additional foci of neoplasm/metastases or a small foci of ischemic change. Further evaluation with an infused MRI examination is recommended. There is no evidence of hemorrhage, midline shift or hydrocephalus.Calvarium, limited paranasal sinuses and mastoid air cells are unremarkable.
1.Large area of vasogenic edema containing a partially cystic and partially solid mass highly concerning for malignancy. Follow-up with an MRI examination with infusion is recommended.2.Small foci of subcortical low attenuation is nonspecific however it may represent a second foci of malignancy or small vessel disease.3.No areas of hemorrhage, midline shift or hydrocephalus.4.Calvarium is intact.