Presentation
Seizures.
Patient Data
The MRI sequences demonstrate:
numerous small subependymal nodules iso to hyperintense to the cortical grey matter on T1 and iso-to hypointense on T2 and T2* (some of them are calcified) with no significant enhancement.
few linear bands of high signal FLAIR and T2 are seen bilaterally in the fronal lobes keeping with radial bands sign.
small heterogeneously enhacing mass (17 mm) obstructing the left foramen of Monro with asymmetrical dilatation of the lateral ventricles and mild transependymal edema.
Annotated images: the green arrow indicates the linear bands of high signal most likely in keeping radial bands sign.
Case Discussion
Case of tuberous sclerosis (or Bourneville disease) showing three major features of the disease according to the tuberous sclerosis diagnostic criteria.
The largest subependymal nodule located at the left foramen of Monro may be considered as a subependymal giant cell astrocytoma, considering its size (>1 cm), marked enhancement following IV contrast, and the obstruction of the ipsilateral foramen of Monro.