Bilateral thalamic glioma

Case contributed by Suhaib Alawaisheh , 25 Nov 2021
Diagnosis almost certain
Changed by Fabio Macori, 22 Jan 2022

Updates to Case Attributes

Status changed from pending review to published (public).
Published At was set to .
Presentation was changed:
Confusion with a headache.
Body was changed:

Bilateral non-enhancing asymmetrical thalami masses resulting in obstructive active hydrocephalus, features highly suggestive of bilateral thalamic gliomas.

Infection is excluded by the clinical picture, the mass effect and no post contrast-contrast enhancement.

Vascular ( ischemic(ischemic venous infarction) is excluded by normal opacification of dural sinuses post contrast-contrast and no restriction diffusion.

The patient was transferred to an oncology centercentre in another hospital, where she was started on chemo and radiotherapy without undergoing a biopsy. Follow up images (not shown) didn't show significant changes.

  • -<p>Bilateral non-enhancing asymmetrical thalami masses resulting in obstructive active hydrocephalus, features highly suggestive of <a href="/articles/bilateral-thalamic-glioma">bilateral thalamic gliomas</a>.</p><p>Infection is excluded by the clinical picture, the mass effect and no post contrast enhancement.</p><p>Vascular ( ischemic venous infarction) is excluded by normal opacification of dural sinuses post contrast and no restriction diffusion.</p><p>The patient was transferred to an oncology center in another hospital, where she was started on chemo and radiotherapy without undergoing biopsy. Follow up images (not shown) didn't show significant changes.</p>
  • +<p>Bilateral non-enhancing asymmetrical thalami masses resulting in obstructive active <a title="Hydrocephalus" href="/articles/hydrocephalus">hydrocephalus</a> features highly suggestive of <a href="/articles/bilateral-thalamic-glioma">bilateral thalamic gliomas</a>.</p><p>Infection is excluded by the clinical picture, the mass effect and no post-contrast enhancement.</p><p>Vascular (ischemic venous infarction) is excluded by normal opacification of dural sinuses post-contrast and no restriction diffusion.</p><p>The patient was transferred to an oncology centre in another hospital, where she was started on chemo and radiotherapy without undergoing a biopsy. Follow up images (not shown) didn't show significant changes.</p>
Diagnostic Certainty was set to .

Updates to Study Attributes

Findings was changed:

There are bilateral asymmetrical thalamic, left basal ganglia and left side of mid brainmidbrain lesions showing low signal intensity on T1WI, high signal intensity on FLAIR and T2WI without surrounding perilesional edema oedema, causing mild shifting of midline structures to the right side.The 3rd ventricle is compressed by the masses with subependymal oedema, indicating active hydrocephalus. No enhancement following IV contrast.

No restricted diffusion.

Normal opacification of all dual venous sinuses.

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