Multiple intracranial meningiomas
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There is a rounded 12 x 12 mm isointense (on T1 and T2) to white mater lesion in the trigone of the right lateral ventricle. It enhances vividly. There is no diffusion restriction. There is associated oedema in the adjacent periventricular white mater suggestive of localised ventricular entrapment.
2 further extraaxial lesions are identified.
There is an enhancing extraaxial lesion in the left superior frontal region measuring 8 x 9 millimetres.
A further 8 x 10 millimetre lesion is seen in the region of the right cribriform plate.
This has central hypointensity and peripheral enhancement and measures 10 x 8 millimetres.
Scattered small foci of increased T2 and FLAIR signal seen in the periventricular and subcortical white matter of the cerebral hemispheres.
The ventricular system appears enlarged in entirety, raising the possibility of a communicating hydrocephalus.
Conclusion: These findings are suggestive of multiple meningioma with the lesion in the trigone of the right lateral ventricle thought to represent an intraventricular meningioma. Given the history of prior metastatic carcinoma, metastases is the main differential diagnosis for this appearance.
Possible communicating hydrocephalus.
MRI brain stereotaxis
Post contrast volume acquisition through the brain has been obtained for the purposes of stereotaxis.