Presentation
Headache. Known tuberous sclerosis.
Patient Data
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Calcified subependymal and to a less extent cortical tubers.
2.6 cm high density mass with intralesional calcification in the right frontal horn close to the foramen of Monro. Early obstructive biventricular hydrocephalus, right much more prominent than left.
Diffusely thickened skull vault.
Case Discussion
These are the typical appearances of tuberous sclerosis with the known complication of a subependymal giant cell astrocytoma, causing hydrocephalus.
The patient was known to have epilepsy and his diffusely thickened skull vault was most likely secondary to anticonvulsant medication.
He proceeded to surgery with histological confirmation of a giant cell astrocytoma.