Brain imaging course – Unknown case 2

This video is the 2nd unknown case that goes with the brain imaging capstone course. If you want to follow along, you can find all the images for the case at the brain capstone page.


60 year-old man with personality changes and lack of motivation with flat affect for 1-2 months

Interactive review

In this case, there is an MRI showing a mass in the bilateral frontal lobes, but more in the right frontal lobe. It crosses the corpus callosum. It is markedly enlarged with FLAIR and T2 hyperintensity, abnormal DWI suggesting high cellularity, and a few areas of hemorrhage on SWI.

On post-contrast imaging, you see a mass with peripheral enhancement and central necrosis (a ring enhancing mass). There are multiple additional areas of enhancement (multifocal enhancement). Findings are very concerning for a high grade tumor, such as a glioblastoma.

Case findings summary

Here you can see screenshots of the findings which we saw in the interactive case review.

Interactive question

What makes this tumor appear high grade? Central necrosis, thick nodular rind of enhancement, multifocal enhancement, restricted diffusion, crosses midline (corpus callosum) 

Diagnosis and Summary

This is a case of glioblastoma. These are high grade tumors of the brain which have a very poor prognosis, and are one of the few aggressive lesions which will cross from one side of the brain to the other. This is a classic appearance of GBM.

Thanks for tuning in to this case. There are a total of 7 cases you can review on your own at the website and explanations will be posted here.

See all of the brain course videos on the brain course playlist, or go back to the brain capstone course page.