Bilateral non-enhancing asymmetrical thalami masses resulting in obstructive active hydrocephalus features highly suggestive of bilateral thalamic gliomas.

Infection is excluded by the clinical picture, the mass effect and no post-contrast enhancement.

Vascular (ischemic venous infarction) is excluded by normal opacification of dural sinuses post-contrast and no restriction diffusion.

The patient was transferred to an oncology center in another hospital, where she was started on chemo and radiotherapy without undergoing a biopsy. Follow up images (not shown) didn't show significant changes.