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Headache, Nausea, And Speech Difficulty


Consult Page

51 F p/w headache, nausea, and speech difficulty, MRI large mass.

Initial Imaging

Figure 12.1, Coronal (A), axial (B), and sagittal (C) T1-weighted MRI with contrast demonstrate a large homogenously enhancing extra-axial lesion of the right frontal convexity. The mass is causing significant mass effect on the surrounding brain parenchyma with midline shift and compression of the ventricular system. Axial T2-weighted MRI FLAIR sequence (D) demonstrates significant tumor-associated vasogenic edema (arrow).

Walking Thoughts

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    What is the patient’s mental status and neurological exam?

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    Are the neurological findings due to the mass effect or are they seizures?

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    How long has she been having symptoms?

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    Is she actively seizing?

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    Has she received anti-seizure medication? Will this affect the neurological exam?

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    Does she require admission?

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    Does she require additional imaging?

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