CincyKidsRad

Cincinnati Children's Radiology

Cerebellar pontine angle meningioma

Coronal T1-weighted image (image 1) shows a meningioma (arrow) at the right cerebellar pontine angle. After contrast was administered (image 2), there is diffuse enhancement of the lesion with minimal thickening and irregularity of the adjacent petro clival ligament and lateral margin of the right tentorium. Enhancing cerebellar pontine angle masses typically represent either a vestibular schwannoma or a meningioma. While this is the most common location for a meningioma in the posterior fossa, vestibular schwannomas are more common. Differentiation of the lesions can be difficult. The presence of a dural tail may help to confirm a diagnosis of meningioma.

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Axial noncontrast CT (image 1), contrast-enhanced CT (image 2), FLAIR MRI (image 3), and T1-weighted postcontrast MRI (image 4) display a diffuse intrinsic pontine glioma (arrow) in the right lateral aspect of the pons. Diffuse intrinsic pontine glioma (DIPG) is an aggressive brain tumor primarily affecting children between 5 and 10 years of age. Nearly 80% of DIPGs exhibit a mutation of the H3K27M gene. Symptoms can include diplopia, facial weakness, ataxia, dysmetria, and dysarthria. Unfortunately, the prognosis is poor, with a 10% 2-year survival rate.

Axial T1 postcontrast MRI shows a large meningioma (arrow, image 1) near the vertex. More inferiorly (image 2), there is also a meningioma at the base of the skull at the sella (arrow, image 2). A large right vestibular schwannoma (arrowhead) is also present. Neurofibromatosis type II is associated with multiple schwannomas, meningiomas, and ependymomas. Meningiomas can cause cortical thickening and irregularity.

This 44-year-old male presents with back and right leg pain. Take a look at the two images, then follow up to see these images with arrows highlighting key areas. Q1 - The most likely diagnosis is: (a) Schwannoma (b) Meningioma (c) Epidural lipomatosis (d) Synovial cyst

Axial T2 (image 1), T1 postcontrast (image 2), and FLAIR (image 3) MRI of the brain in an in an asymptomatic adolescent with an epidermoid cyst shows a cystic lesion involving the right superior frontal gyrus. There is no significant effect on the underlying brain with minimal adjacent edema or mass effect. The mass does not enhance, has mild heterogeneous signal on the FLAIR sequence, and showed restricted diffusion (not shown). Epidermoid cysts most commonly occur at the cerebellar pontine angle or the region of the fourth ventricle. Characteristic features include the heterogeneous signal on FLAIR sequence and restricted diffusion.

A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis. He had a history of hypertension, long-term smoking, and a sedentary lifestyle. On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.

A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back. She reported no recent travel or exposure to new environments. She cares for a small kennel with approximately eight dogs rescued from the streets. Physical examination revealed multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and the left gluteal area.

A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.

patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family, are there any features in this ekg that would warrant further work-up or is this just a pediatric ekg?