Aphasia in a 81 year old man

by

Michael H. Rivner, M.D.

This is an 81 year old man who was in previously good health until the evening of admission when he suddenly developed the onset of aphasia.  Following this he had a generalized tonic-clonic seizure which lasted about a minute.  When he was examined he was alert but had both an expressive and receptive aphasia.  He was unable to follow even simple commands and his speech was unintelligible but not dysarthric.  He had no visual field loss as best as can be told.  He did not appear to have any weakness including facial weakness.  He does not appear to have any sensory loss as best as can be determined.  He had normal reflexes.  He was put on Keppra and had no further seizures.  The day of admission, he underwent a CT scan which gave the suggestion of a possible mass in the left temporal-parietal region.  He did not get contrasted and their was a concern for a brain tumor.  He now been in the hospital for 2 days and there has been no worsening or improvement.  This MRI was obtained yesterday.  I am interested in what list members think of this scan.  Is this just a stroke, or is this a tumor or an inflammatory condition?

MRI Scan


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(c) 2010  M.H. Rivner

 

August 22, 2010