Magnetic resonance imaging of the brain revealed a giant pituitary adenoma measuring

Magnetic resonance imaging of the brain revealed an arachnoid cyst, measuring 12.3 cm by 16.5 cm by 7.9 cm, with mass effect on the right cerebral hemisphere; the cyst was causing displacement of the temporal lobe superiorly and posteriorly and a shift of midline structures. #Clinical #Radiology #MRI #Arachnoid #Cyst #ArachnoidCyst #NEJM

Nystagmus from Wernicke’s Encephalopathy - Magnetic resonance imaging of the brain showed T2 hyperintensities involving the periaqueductal white matter (Panel A, arrow) and bilateral thalami (Panel B, arrows). #Clinical #Radiology #Neuro #Wernicke #MRI #Thalamus #NEJM

Creutzfeldt-Jakob Disease - Magnetic resonance imaging (MRI) revealed hyperintensity of the cortical gyri of the frontal and occipital lobes, called cortical ribboning (Panel A, arrow), and within the caudate heads on both sides (Panel B, arrows) on diffusion-weighted imaging. #Clinical #Neuro #Radiology #MRI #CreutzfeldJakob #NEJM #Prion

Central Pontine Myelinolysis - Magnetic resonance imaging of the brain revealed a central area of high T2 (Panel A, arrows) and low T1 (Panel B, arrow) signaling in the pons, with restricted diffusion (Panel C, arrows). #Clinical #Radiology #Neuro #MRI #Central #Pontine #Myelinolysis #CPM #Osmotic #Demyelination #Syndrome #ODS #NEJM

Metronidazole-Associated Encephalopathy - A magnetic resonance imaging (MRI) scan of the brain showed a symmetric, enhanced fluid-attenuated inversion recovery (FLAIR) signal in the dentate nuclei of the cerebellum (Panel A, arrow), a finding that is consistent with encephalopathy associated with metronidazole use. Discontinuation of metronidazole resulted in resolution of the imaging findings 1 month later (Panel B) #Clinical #Radiology #Pharm #MRI #Metronidazole #Encephalopathy #Cerebellum #NEJM

Trypanosoma cruzi Reactivation in the Brain- ...Magnetic resonance images of the brain showed a mass measuring 8 by 7 by 6 cm in the corpus callosum and the white matter of the right parietal and occipital subcortical lobes (Panels A and B, with images obtained on T2-weighted imaging and on T1-weighted imaging, respectively, after the administration of contrast material). Cytologic examination of a brain aspirate revealed intracellular organisms (Panel C), with prominent kinetoplasts (masses of mitochondrial DNA) (arrow) visible within macrophages and astrocytes. The organisms were identified as Trypanosoma cruzi on the basis of partial protozoal 28S ribosomal RNA sequencing... #clinical #NEJM #trypanosoma #cruzi #reactivation #brain #MRI #radiology

Mobile Aortic Thrombi - Gated aortic magnetic resonance imaging revealed four intraaortic thrombi (arrows) attached to the wall of the descending aorta that moved in synchrony with the cardiac cycle #Clinical #Radiology #MRI #AorticThrombi #MobileThrombi #NEJM

Giant Thrombosed Intracranial Aneurysm - Computed tomography (CT) performed without the administration of contrast material revealed a large left frontotemporal mass with areas of calcification (Panel A). CT angiography and magnetic resonance imaging (Panels B and C) also revealed the mass without contrast enhancement or intraluminal filling, which raised suspicion of a thrombosed aneurysm that was likely to have originated from the bifurcation of the middle cerebral artery. #Clinical #Radiology #Neuro #CT #MRI #Thrombosed #Intracranial #Aneurysm #NEJM

Gadolinium-enhanced magnetic resonance imaging (MRI) of the head showed a solid, enhancing lesion on the T1-weighted sequence, with a butterfly appearance that extended across the corpus callosum (Panel A). Hyperintensity of the mass was observed on the T2-weighted sequence (Panel B), and restricted diffusion was seen on diffusion-weighted MRI. #Radiology #MRI #ButterflyGlioma #Glioblastoma #NEJM

Gartner’s Duct Cyst - A physical examination revealed a smooth, nontender mass, 5 cm in the longest diameter, in the midline of the anterior wall of the vagina (Panel A). There was no evidence of pelvic-organ prolapse. A cystoscopic examination did not reveal a urethral or bladder diverticulum. Magnetic resonance imaging of the pelvis (Panel B) with contrast medium inserted into the vagina revealed a cystic structure (G) located between the bladder (B) and the vagina (V). #Clinical #Obgyn #Radiology #MRI #GartnersDuctCyst #Gartner #Congenital #NEJM