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Young male with headache
.Differentials include
Vein of galen aneurysm-
.normally presents early
.straight sinus will be full and dilated
.multiple flow voids with thrombosis likely
.Sup sag sinus will also be full
.DW could show penumbra of restriction
Pilocytic astrocytoma----------possible
.unusual location
.Flow voids unusual as it is low grade tumour
.perilesional oedema possible
Epidermoid---------------------possible
.No restriction on diffusion
.normally does not enhance
Pineal gland tumour-------possible
.usually midline
.heterogenous enhancement
.goes to flooor of third ventricle
What we suggested is haemangioblastoma
.unusual location
.nodule is typical
.Bleed not present
.no oedema usually
Case by Dr MGK Murthy
Teleradiology Providers
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"The owner heard metal-on-metal noises outside, found his cat had been shot in the head (by the neighbor) with an arrow. On presentation, the cat was alert and purring. The arrow was removed & the cat is doing great. Neighbor is facing charges."
Interesting Case of Unfortunate Trauma to Kitten -on radRounds
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While recovering from tuberculous meningitis, patient developed a profound visual deficit because of optochiasmatic arachnoiditis. Revealed on contrast MRI as nodular and rim enhancing areas in the region of the optic chiasma.
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Case of ophthalmoplegia. CT scan reveals cavernous sinus thrombosis
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Acute cerebellitis is an uncommon clinical entity . It is usually manifested in children. It produces imaging features of cerebllar hemispheric or vermian or both oedema with apparently normal supratentorial compartment. Obstructive hydrocephalus due to aqueductal nannrowing due to oedema is possible The usual agents are viral and amongst them herpes as well as epstein barr virus predominate. In our country it should not be mistaken for Tuberculosis as findings could mimic with leptomeningeal and tentorial enhancement. On admnistration of acyclovir pt may deteriorate if steroid is withheld. Post contrast imaging shows intravascular enhancement (i.e. seeing vessels better in the ROI) which is typical for acute stroke and vasculitis. The etiology of the MRI signal changes and enhancement in cerebellitis remains speculative. The cerebellar swelling and parenchymal signal changes most likely reflect encephalitis with edema and inflammation. The hyperintensities on T2-WI involved the cerebellum diffusely and symmetrically, including the vermis and cerebellar hemispheres; the grey matter appeared more abnormal than the white matter.
Case by Dr MGK Murthy
Sr Consutlant Radiologist
Teleradiology Providers
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