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CLINICAL NOTES:A few weeks increasing confusion, non-specific presentation, heavy ETOH use. ? Falls, nil gross focal signs on examination.
FINDINGS:Pre- and post-intravenous contrast scan performed.There is a large approximately 7 cm strongly enhancing mass lesion which appears lobulated present in the subfrontal region mainly in the midline and towards the left side associated with marked oedema and mass effect on the adjacent sulci and the frontal horns of the lateral ventricles, both of which are deformed and the left is dilated. The remainder of the ventricles are within normal limits. The lesion appears hyperdense on the unenhanced scan and contains calcifications. The lesion abuts the inner table of the skull. There is anterior midline shift towards the right side given the bulk of the lesion is in the left frontal region. No acute intra or extra-axial bleed shown. No other focal abnormal enhancing mass lesion demonstrated.
CONCLUSION:The appearances are most in keeping with a large frontal meningioma associated with surrounding oedema and mass effect.