Concluded Case

Ependymoma arising from 4th ventricle with obstructive hydrocephalus.

New case. 46 yr ,F, No known diseases or med ,presented with 7 months history of intermittent head ache ,more in the morning hours.At times she is getting vertigo intermittently, subjective in nature with nausia responding to Cinnarazine. Since 2 weeks she has mild difficulty in walking in the firm of unsteadiness .No definite motor weakness.On exam BP 140/ 80 mmhg . Optic fundi early papilledema with difficulty in tandom walking . DTRs equal. No neck stiffness. Whata abnormality in the MRI and what is the diagnosis/ DD.

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Concluded answer
Tanks to all who answered . Discussion what abnormality into MRI& what is the diagnois? Diagnosis: MRi Ependymona / Medulloblastoma. surgery done : Ependymoma. MRI brain: A well defind heterointense lesion noted in the 4th ventricle with T2 hyperintense and iso to hypointense on T1w signals. Post contrast fat saturated sequence shows moderate heterogeneous enhancement.Lesion shows multiple T2 hyperintense foci with signal suppression on FLAIR and low signals on T1 images suggestive of cystic lesion. Lesion appears to be arising from inferior aspect of floor of 4th ventricle.Lesion is causing mass effect in the form of compression of bilateral cerebellar hemispheres, vermis, b/ l inferior and middle cerebellar peduncles.Extension of enhancing tumor noted in the Rt superior cerebellar peduncle and rt foramen of Lushka.Bilateral lateral ,3rd ventricles,foramen of Monroe,aqueduct appears dilated. MRI spine with contrast also done- normal. Patient is better.
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Posterior fossa mass in 4th ventricle region causing supra tentorial hydrocephalus. Likely ependymoma. PNET ,MEDULLOBLASTOMA
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Tanks to all who answered . Discussion what abnormality into MRI& what is the diagnois? Diagnosis: MRi Ependymona / Medulloblastoma. surgery done : Ependymoma. MRI brain: A well defind heterointense lesion noted in the 4th ventricle with T2 hyperintense and iso to hypointense on T1w signals. Post contrast fat saturated sequence shows moderate heterogeneous enhancement.Lesion shows multiple T2 hyperintense foci with signal suppression on FLAIR and low signals on T1 images suggestive of cystic lesion. Lesion appears to be arising from inferior aspect of floor of 4th ventricle.Lesion is causing mass effect in the form of compression of bilateral cerebellar hemispheres, vermis, b/ l inferior and middle cerebellar peduncles.Extension of enhancing tumor noted in the Rt superior cerebellar peduncle and rt foramen of Lushka.Bilateral lateral ,3rd ventricles,foramen of Monroe,aqueduct appears dilated. MRI spine with contrast also done- normal. Patient is better.
Cerebellar ischemia.... .There is insufficient blood flow to the brain to meet metabolic demand. This leads to poor oxygen supply or cerebral hypoxia and thus to the death of brain tissue or  cerebral infarction / ischemic stroke.
Thank you doctor
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hyperdense circular lesion in cerebellum herniation stroke
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Cerebellar mass with hydrocephalus
Valuable opinion
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CVA Ventricles inflamtion
Posterior fossa tumor
Cerebellar Infarction
Cerbeller ischemia
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MEDULLOBLASTOMA

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