Clinical History: A 40 year old male presented with many months history of altered behaviour with excessive sleep. H/o trivial fall from chair one day prior to MRI scan.
Imaging Findings: Patient referred for plain & contrast enhanced MR imaging:
MRI findings revealed:
- Poorly defined, diffuse lesion showing altered signal intensity in the deep periventricular white matter around right occipital horn, splenium of corpus callosum on both sides, subcortical white matter of right temporal and parietal lobes. It was also seen to extend to lateral part of right thalamus and cerebral peduncle, right external and internal capsules. Diffuse altered signal intensity was also seen in the dentate nuclei on both sides and in the dorsal part of the pons.
- The splenium of corpus callosum and involved deep white matter was expanded.
- No enhancement seen in these regions on post contrast study.
- No evidence of hemorrhage or calcification.
- Evidence of mass effect noted on right lateral ventricle with midline shift to left by 1.1 cm. No hydrocephalus.
Imaging Diagnosis: Findings compatible with Gliomatosis Cerebri.