Presentation
Headache and seizures
Patient Data
A well-defined complex mass lesion with cystic and solid components showing a lobulated pattern in the midline.
Resultant dilatation of both lateral ventricles with trans ependymal edema is noted.
Solid components of the mass lesion demonstrate intermediate signal intensities on T1 and T2 weighted depicting avid post contrast enhancement and peripheral diffusion restriction on DWI/ADC map.
Multiple subependymal plaques noted bilaterally, some of them are enhancing after contrast administration and showing dropout signal on T2*GRE images.
Cortico-subcortical T2/FLAIR high signal intensity lesions in both cerebral hemispheres without contrast enhancement.
Case Discussion
Features compatible with tuberous sclerosis evident by subependymal and subcortical tubers associated with a subependymal giant cell astrocytoma. Echocardiography for cardiac structure and abdominal ultrasound for kidneys are helpful to find associated abnormalities.
This case is contributed by Dr. Naqibullah Foladi, and Dr. Mohammad Tahir Aien.