Presentation
Pounding headache and photophobia
Patient Data
Age: 30 years
Gender: Male
From the case:
T2/FLAIR mismatch sign
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MRI of the brain demonstrates a circumscribed mass in the anterior right frontal lobe with very hyperintense signal on T2WI. On FLAIR, there is relatively hypointense signal due to incomplete suppression with a peripheral rim of hyperintensity.
Case Discussion
This is a case of the classic appearance of the T2/FLAIR mismatch sign in an IDH-mutant, 1p19q non-codeleted astrocytoma which was pathologically proven upon resection. The T2-FLAIR mismatch sign has a 97% specificity for IDH mutant astrocytoma.
Co Author: Daniel P. Gewolb, MD
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