There is evidence of a fairly well-defined ,large, hetero-intense lesion , predominantly T2W hyperintense not showing restricted diffusion noted in the right high parietal , posterior temporo-occipital region The occipital horn of the right lateral ventricle cannot be appreciated separately from the lesion. It shows focal calcifications.

 

The lesion has both supra-tentorial and infra-tentorial extensions

Anteriorly it is involving the thalamus on the right side.

Medially it is crossing the midline compressing the splenium of corpus callosum.

Laterally it is compressing the occipital horn of the right lateral ventricle.

Posteriorly it is extending into the right temporal lobe causing mild effacement of the temporal horn of right lateral ventricle.

-Inferiorly it is extending into the occipital lobe and extending infra-tentorially into the vermis of the cerebellum and the tectal plate of the mid-brain.

 

There is mass effect as evidenced by a midline shift of 7mm to the contra-lateral side ,compression of the third ventricle,mid brain and aqueductal obstruction causing upstream dilatation of the anterior third ventricle and bilateral lateral ventricles.

Mild compression of the 4th ventricle noted.

There is effacement of the quadrigeminal and ambient cistern.

 

T2W  hyperintensities noted in the periventricular region and frontal nd parietal deep white matter-S/O chronic small vessel ischemic changes.