Innumerous brain metastases

Case contributed by Dr Craig Hacking

Presentation

Worsening headache and nausea over a week. Hx of breast cancer.

Patient Data

Age: 30-35 years
Gender: Female
CT

There are innumerable small enhancing lesions throughout both cerebral and cerebellar hemispheres and brainstem. Vasogenic edema is seen associated with the larger of these lesions. Several of these lesions appear to be mildly hemorrhagic, particularly in the right tectal plate and right posterior frontal lobe. There is no hydrocephalus or midline shift. No acute cortical infarct or intracranial hemorrhage. Opacification of left mastoid air cells. The imaged paranasal sinuses are aerated. No suspicious bony lesion.

Conclusion

Substantial burden of intracranial metastatic disease.

Case Discussion

Great illustration of how a non contrast CT head can significantly downplay the extent of intracranial metastases.

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Case information

rID: 42310
Published: 6th May 2016
Last edited: 16th Jul 2018
Inclusion in quiz mode: Included

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