Tuberous sclerosis

Case contributed by Abdulazez Khaled
Diagnosis certain

Presentation

9 year old presented with seizures

Patient Data

Age: 9 Year old
Gender: Male
mri

There is lobulated heterogeneous soft tissue mass noted at the level of foramen of Monro, measuring approximately 2.5 x 2 x 1.6 cm, which appears isointense in T1, slightly hyperintense T2 and FLAIR sequences, causing dilatation of the supratentorial ventricular system, with significant enhancement in postcontrast images, no diffusion restriction is seen, Small patchy area of abnormal signal intensity in periventricular representing CSF permeation, indicating acute hydrocephalous.

Small enhancing subependymal nodule seen in the posterior horn of the left lateral ventricle.

Bilateral scattered signal abnormalities identified in the subcortical region, which appears hyperintense in T2 and FLAIR sequences, mostly represents subcortical tubers/hamartomas.

No acute hemorrhage, territorial infarction, mass effect, or midline shift.

Normal posterior cranial fossa.

IMPRESSION

Lobulated heterogeneous soft tissue mass at level of foramen of Monro, mostly represents Giant Cell Astrocytoma, associated with acute supratentorial hydrocephalous. Multiple subcortical tubers/ hamartomas, with subependymal nodule in the posterior horn of the left lateral ventricle. The overall picture is consistent with Tuberous Sclerosis.

 

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