- 11 yo M presented with headaches
- No PMH, PSH, or meds
- Normal function in school
- Neurologically intact
1. What would not be in your differential diagnosis?
2. What would the best initial workup include?
3. What initial treatment would you offer this patient?
4. What potential adverse outcomes would NOT be expected?
5. Which of the following describes you?
6. I practice in one of the following locations:
7. Please add any suggestions or comments regarding this case:
- Given the signal intensity in T1WI and the heterogeneous nature of the lesion..... I'd be inclined to think of a dermoid versus and craniopharyngioma. The absence of manifestations is more suggestive of the dermoid. The preservation of the T1WI hyperintense signal of the posterior pituitary in the sagittal MRI suggests the hypothalamus isn't affected functionally; so it the neurohypophysis. because of this, diabetes insipidus is not a first possibility although it's likely to occur with progression of the disease. In the given sagittal MRI, there is an obvious separation of the lesion parts by the liliequest membrane suggesting it has spread to the interpeduncular cistern.... this is more consistent with an epidermoid.
- An interesting case
- Complex case
- Good series..
- Good series..
- Treatment would be depend on results of additional w/u.
- A tricky case
- The MRI pictures are only T1. We could need T2 and FLAIR sequences. A CT scan could be also useful. The Hypothesis of theratoma or craniopharingioma may be confirmed with these details. Other diagnosis seem to be improbable. Pilocitic astrocytoma could be a third choice. I need more neurodiagnostic images
- The intial clinical evalution will be followed by ct scan ,others steps ,as endocrine-ophthalmogy, mri are very important. Management will depends on the results of workup surgically may be open or by endoscope if is present,and neurosurgeon expierince
- I would include TNTS approach
- Why wasn't a transsphenoidal approach an option?
- The lack of Optic Nerve compression and the MRI suggest this be a cystic lession, probably a Craniopharyngioma but the hyperintensity does not fit. Surgery can remotely produce an Internal carotid lesion