Presentation
Headache
Patient Data
Predominantly solid lesion with small areas of cystic degeneration / necrosis and possible foci of hemorrhage in posterior fossa in midline. Lesion is expanding the 4 th ventricle, splaying bilateral middle cerebellar peduncles and brainstem anteriorly. No obvious extension of lesion is seen into foramen of Magendie or Luschka. Cerebellar vermis is not well visualized separately. Lesion shows diffusion restriction with mild heterogeneous enhancement on post contrast study.
Cerebellar tonsils are herniating inferiorly and lie 9.8mm below foramen magnum.
Right parietal burr hole craniotomy is seen with VP shunt in situ.
No evidence of hydrocephalus is seen in present scan.
No significant focal lesion or abnormal enhancement is seen in supratentorial brain parenchyma.
Case Discussion
Findings suggest likelihood of a medulloblastoma.
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