CASE 50: MRI Brain

55M, convulsions


Gliobastoma Multiforme with spread along white matter tracts


the most common adult primary intracranial neoplasm, and has the worst prognosis

association with p53 mutation related syndromes such as NF1 

typically poorly-marginated, diffusely infiltrating necrotic masses 


varied appearance on MRI but usually hypo-iso (T1) and hyper (t2/FLAIR), enhance vividly, with significant edema, mass effect, and also hemorrhage

Typical appearance as of tumors on MRS with increase in choline and lactate 

Poor prognosis - average survival after discovery is 12-18 months