Case 375

Case 375

Medical History

A 59-year-old man presented with a one-month history of headache, reduced visual acuity, difficulty with balance and walking and intermittent episodes of memory loss. On examination, patient was alert, oriented, with right homonymous hemianopsia at confrontation testing of the visual field, lowering of the right lower limb during the Mingazzini manoeuver and right hemiparetic gait. Magnetic resonance image (MRI) of the brain is shown (Images 1-4).

Considering the clinical and radiological findings, what is the most likely diagnosis?

Test Question

(CESPE-UnB – Medical Residency Examination, 2009).

Nowadays, computed tomography (CT) and/or magnetic resonance image (MRI) are essential for diagnosis and monitoring of brain tumors. These imaging exams allow the description of some typical characteristics that influence even in the choice of the best area for biopsy. Regarding this subject, choose the right answer.