Hemorrhagic cerebral metastases

Case contributed by Ayush Goel
Diagnosis almost certain

Presentation

Right-sided weakness followed by altered mental status.

Patient Data

Age: 45 years
Gender: Female
This study is a stack
Axial
non-contrast
This study is a stack
Axial C+
arterial phase
This study is a stack
Axial C+
delayed
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Info

Non-contrast

  • large intra-axial space-occupying lesion with peripheral hyperdensity and central hypodensity in the left hemisphere (fronto-parietal region, extending into corona radiata and internal capsule)

  • with surrounding edema and mass effect - compressing left lateral ventricle, effacement of sulcal spaces and midline shift (about 14mm) to right

Post-contrast and delayed 

  • shows peripheral enhancement

Case Discussion

This patient had a history of Breast cancer treated surgically with post-op, chemoradiotherapy. Imaging features are consistent with cerebral metastases with peripheral hemorrhage and central necrotic area in a known case of breast cancer.

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