PMC7273552_01
The contrast-enhanced computed tomography scans showing a cystic-like
lesion at the level of the internal capsule on the left side.
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The brain CT scan revealed a left-sided lesion in the level of the basal ganglia invading the internal capsule with edema (Figure 1).
The coronal view on the T1WI shows a peripheral hyperintense rim with
hypointense signals within the lesion.
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On T1WI, the peripheral rim of the lesion showed hyperintensity with hypointense content (Figure 2).
The post-Gd, T2 FLAIR and DWI sequences of the lesion, showing peripheral
rim enhancement with surrounding white matter edema.
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It is important to mention that surrounding white matter edema was observed in the above-mentioned sequences (Figure 3).
The microscopic findings and features of the biopsied tissue, showing
confluent central necrosis containing necrotic debris and neutrophils as
well as poor demarcation from the adjacent brain parenchyma.
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There were small areas of edematous brain tissue also present with swollen reactive astrocytes, but with no obvious granulation tissue formation (Figure 4).
The control postoperative magnetic resonance imaging scans after 3 months
show a significant regression of the lesion.
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The patient had a control brain MRI in 3 months and the MRI scans showed a significant decrease in the mass of the lesion as well as a significant decrease in the peripheral edema (Figure 5).
The contrast-enhanced magnetic resonance imaging scans after 1 year show
a complete regression of the lesion on the left side. Some artifacts of
the biopsy can be seen in the surroundings of the surgical site.
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The patient was controlled after 1 year, the physical examination did not reveal any neurological deficits, and the contrast-enhanced brain MRI showed a complete regression of the lesion (Figure 6).