Case Notes
History
53 yo female with dizziness and gait imbalance. Prior history of breast cancer. Meningeal biopsy=nonspecific organizing pachymeningitis on biopsy.Exam
MR Diffusion
Prior Study
T2-w spin-echo axial MR1. Significant external hydrocephalus with features of significantly increased CSF pressure including early downward herniation effects.
2. No definable cause for the hydrocephalus is evident on this MR sequence.
Sagittal post contrast MR
1. Obstructive type of external hydrocephalus with early downward herniation effects clearly delineated and graded, as above.
MR flair
1. Significant external hydrocephalus with features of significantly increased CSF pressure including early downward herniation effects.
2. No definable cause for the hydrocephalus is evident on this MR sequence.
Post contrast T1-w MR
1. Abnormal pial enhancement mainly in the posterior fossa; basis for the pachymeningitis is indeterminate. 2. Biopsy is likely necessary if a diagnosis is to be determined.