Presentation
Sudden loss of consciousness and fell down.
Patient Data
A large crossing-midline intra-axial mass at the genu of corpus callosum complicated with hemorrhage. It is associated with perilesional edema and expansion of corpus callosum.
"Swirl sign" within the hemorrhagic mass (acute extravasation of blood into hematoma).
Hemorrhage extends into the ventricles as acute intraventricular hemorrhage and into the basal cisterns as acute subarachnoid hemorrhage.
Hydrocephalus with periventricular lucency which may represent transependymal CSF seepage.
Basal cisterns are effaced.
Evidence of previous left fronto-parietal craniotomy with left parietal lobe encephalomalacia from previous insult.
Case Discussion
Differential diagnoses for brain tumor located across the midline at the genu of corpus callosum include high grade butterfly glioma (high grade astrocytomas, IDH-mutant or glioblastomas, IDH-wildtype), primary CNS lymphoma,tumefactive demyelination and cerebral metastases (rare).
In this case of massive hemorrhage from the tumor resulting in diffuse subarachnoid hemorrhage and interventricular hemorrhage, the most likely diagnosis will be high grade glioma, though there are a few reported cases of primary CNS lymphoma.
No definite diagnosis for this case, as patient and family refused for further imaging investigation and histopathology examination.
Unable to process the form. Check for errors and try again.