Brain metastases (breast carcinoma)
Giddiness and one episode of loss of consciousness. Suspected transient ischemic attack.
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Well defined T1 hypointense, T2 hyperintense, intensely enhancing intra-axial lesions with perilesional vasogenic edema are seen in grey white matter junction of left frontal and parietal lobes, left thalamus, right paramedian dorsal midbrain and pons, right external capsule and superior temporal gyrus, left half of cerebellar vermis and right cerebellar hemisphere.
No vascular thrombosis or features of raised intracranial pressure. No acute infarction or acute intracranial hemorrhage.
Brain secondaries are becoming more common thanks to better survival rates of cancer patients. Approximately 10-16 % of patients metastasize to brain, around 50 % of HER2 positive breast cancers.