Presentation
Limb weakness. Additional history withheld.
Patient Data
Diffusely bulky spinal cord, which shows extensive heterogeneous enhancement. Multiple surface and nodular enhancing lesions in the surface of spinal cord. These represent metastatic involvement. Nodular enhancing lesion at L4 to S1 vertebral levels in the spinal canal, represent drop metastasis.
Postoperative and post VP shunt status.
Mild pinching of both the lateral ventricles with thin extra axial subdural stripe seen in the both cerebral convexity. Possibility of underlying shunt over drainage should be ruled out.
Multiple altered signal enhancing areas in the both cerebellar hemisphere, adjacent to fourth ventricle, pons, left basi frontal region, perimesencephalic cistern, prepontine cistern, ambient cistern and interpeduncular cistern.
Case Discussion
This patient had been operated for medulloblastoma and had received radiotherapy. Unfortunately they developed extensive recurrent disease.