q4207 [Neurosurgery Wiki]

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====== 	q4207 ======

73-year-old patient, admitted for a infiltrative [[lesion]] highly suggestive of [[Primary leptomeningeal lymphoma]].

===== Past Medical History =====

[[Hypercholesterolemia]]

[[Depression]]

[[Hydrocephalus]]. [[Endoscopic third ventriculostomy]]

==== Treatment ====
[[Simvastatin]]

[[Desvenlafaxine]].
===== History of the present illness =====

Abnormal [[gait]] with [[instability]] and a feeling of magnetism in it, accompanied by [[bradypsychia]] and occasional [[memory]] failures. 
===== Test results =====



==== MRI ====
{{::q4207mripreop.jpg?400|}}

Regarding the last previous control, there are no significant variations, however, when comparing the evolution of the previous studies over the last 2 years, a constant progression is identified both in [[FLAIR]] and in the diffusion of [[periventricular]] predominance, especially at the right [[parietal]] level, with involvement of the [[splenium]] of the [[corpus callosum]] and in the right hemi[[protuberance]] in the last 2 studies, both in diffusion and in FLAIR, with a progressive increase in uptake, without clear images of [[mass effect]] at the current time. The lesion is highly suggestive of lymphoma.