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A 23 year-old man developed headaches, memory loss and impaired upgaze over two months.
MRI Axial Flair scans. Note the lesion in the upper midbrain (left image) extending into both posterior and medial thalami (middle and right images). On gadolinium scans, this lesion did not enhance. Also, note that there is very little mass effect. This is a low grade glioma. Low-grade astrocytomas make up 15% of all primary intracranial brain tumors, and usually occur in young adults. Although biopsy is required to make a definitive diagnosis, the lack of contrast enhancement favors the diagnosis of a low grade glioma rather than a glioblastoma.
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