Presentation
Headaches, vertigo with altered level of consciousness in a patient treated for lung cancer.
Patient Data
Innumerable scattered enhancing intra-axial lesions of various sizes, disseminated in both cerebellar and cerebral hemispheres with no significant surrounding vasogenic edema. The lesion adjacent to the trigone of the right lateral ventricle shows restricted diffusion.
Diffuse leptomeningeal enhancement mainly in the infratentorial subarachnoid spaces seen as linear and nodular enhancement along the surface of the cerebellum and brainstem in keeping with leptomeningeal metastases.
Numerous skull lesions of a low signal on T1, and T2 (probably sclerotic metastases).
Moderately dilated ventricular system with partially empty sella.
Case Discussion
The MRI features of multiple enhancing intra-axial cerebellar and cerebral lesions with leptomeningeal enhancement in a patient treated for lung cancer are most consistent with brain metastases.
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