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A Ball in the Brain!

Topic: Anatomy

Created on Thursday, October 23 2008 by rednucleus

Last modified on Thursday, October 23 2008.

A 57-year-old woman presents with vague personality changes. Her neurological examination is non-focal but her brain MRI is suggestive of a frontal lobe meningioma, semirounded, and is 3 by 4 cm in maximum diameter. The report adds "with underlying brain edema." How would explain this brain edema?

A) There is co-existent superior sagittal sinus thrombosis

B) It could be a nasopharyngeal carcinoma

C) This is a craniopharyngioma

D) This is an atypical meningioma.

E) This is a cordoma

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This question was created on October 23, 2008 by rednucleus.
This question was last modified on October 23, 2008.

ANSWERS AND EXPLANATIONS

A) There is co-existent superior sagittal sinus thrombosis

This answer is incorrect.

The CT scan can be normal-looking, or shows bilateral paracentral venous infarction with hemorrhagic components. (See References)


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B) It could be a nasopharyngeal carcinoma

This answer is incorrect.

This is a malignant tumor with invasive properties and multiple cranial nerve palsies. (See References)


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C) This is a craniopharyngioma

This answer is incorrect.

A suprasellar mass with calcification. Rare in middle-aged adults. (See References)


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D) This is an atypical meningioma.

This answer is correct.

Meningiomas are benign extra-axial tumors that compress the underlying brain with no edema formation. The presence of associated brain edema should prompt the neurologist think of atypical meningioma, secretory meningioma, or frankly malignant meningioma (all of them are rare). (See References)


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E) This is a cordoma

This answer is incorrect.

Localizes to the clivus mostly; one of the causes of clivus enlargement and destruction. (See References)


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References:

1. Victor, M., and Ropper, A.H. (2001). Adams and Victor's Principles of Neurology, 7th Edition. McGraw-Hill, New York. (ISBN:0070674973)

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anatomy
A Ball in the Brain!
Question ID: 102308090
Question written by rednucleus. (C) FrontalCortex.com 2006-2009, all rights reserved. Created: 10/23/2008
Modified: 10/23/2008
Estimated Permutations: 120