Presentation
Ataxia.
Patient Data
The MRI sequences demonstrate an ill-defined mass enlarging the brainstem and encasing the basilar artery, distal portion of the vertebral arteries, and the right posterior cerebral artery with effacement of the prepontine, cerebellopontine, and suprasellar cisterns. It displays a low siganal on T1, high signal on FLAIR and T2 with central areas of heterogeneous enhancement and restricted diffusion. A mass effect is noted on the 4th ventricle which is compressed and displaced posteriorly with tonsillar herniation and dilated supratentorial ventricular system in keeping with obstructive hydrocephalus.
Case Discussion
MRI features are suggestive of high grade diffuse brainstem glioma.