Concluded Case

GLIOBLASTOMA MULTIFORME

New case 43r ,M ,From neighbouring state ,no known comorbidities, presented with progressive difficulty to understand others talk 6 months,3 episodes of generalized tonic clonic fit 1st 4 months ago,2nd and 3rd this month ,difficulty in walking with stiffness in the legs 2 months . He also noted prevoidal dribbling incontinence since 1 week. On exam Bp130/ 80 mmhg,optic fundi normal. Speech inappropriate answeres ,mild spasticity both lower limbs ,bilateral hyperreflexes both knees and ankles with extensor plantars.Intact sensations. Walking with mild spastic gait. After MRI brain ,he was ref to the Neurosurgeon.After discussing with Neurosurgreon,he req discharge to go to Govt Medical College due to financial constraints. What abnormality in the MRI and what is the diagnosis? @ Neurologist,Neurosurgeon and Radiologist

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Concluded answer
Thanks Curofy & others. Diagnosis: Glioblastoma multiforme. MRi : Well defindT2W / FLAIR hyperintense T1W hypointense heterogeneously enhancing space occupying lesion noted involving bilateral frontal periventricular white matter, with involvement of corpus callosum ( involving rostrum,genu and body) ,the lesion is extending up to the frontal cortex and crossing the midline to involve the left frontal white matter. Perfusion images show increase in rCBF and r CBF with in the lesion. MRS shows elevated choline peak and decrease NAA level.
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Thanks Curofy & others. Diagnosis: Glioblastoma multiforme. MRi : Well defindT2W / FLAIR hyperintense T1W hypointense heterogeneously enhancing space occupying lesion noted involving bilateral frontal periventricular white matter, with involvement of corpus callosum ( involving rostrum,genu and body) ,the lesion is extending up to the frontal cortex and crossing the midline to involve the left frontal white matter. Perfusion images show increase in rCBF and r CBF with in the lesion. MRS shows elevated choline peak and decrease NAA level.
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Its either a Primary CNS lymphoma or Glioma
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butterfly Glioma
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Thanks Curofy