Presenter
Raymond Wong
Bio
Raymond Wong is a PGY1 Neuropathology resident at the University of Toronto. He completed his PhD at the University of Toronto focused on neuro-oncology and hypoxic-ischemic brain injury.
Authors
Raymond Wong1, Adrian Levine1,2, Cynthia Hawkins1,2
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
- SickKids Hospital, Toronto, ON, Canada
Conflict of Interest
I do not have a relationship with a for-profit and/or a not-for-profit organization to disclose.
Clinical Summary
12-year-old boy, previously healthy, presented to the emergency department with a 1-day history of progressive headache, vomiting, and one episode of syncope.
CT head showed a large acute right parietotemporal intraparenchymal hematoma with perilesional and diffuse cerebral edema causing significant mass effect including 9 mm leftward midline shift, right uncal medialization and ventricular compression. There was no evidence of an underlying arteriovenous malformation or aneurysm within the limitations of CTA/CTV. Additionally, no acute fracture, lytic lesion or periosteal reaction.
The patient received urgent right decompressive hemicraniectomy and biopsy.
Discussion points
- What is the differential diagnosis and immunohistochemical workup?
- What molecular testing would be useful?
- What is the clinical and prognostic significance of this diagnosis?
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