fig 1.

35-year-old man with a history of remote closed head injury who presented with recurrent headache, cortical blindness, and numerous new neurologic deficits.

A, Axial noncontrast CT scan shows increased attenuation of the right temporal lobe, frontal lobes, suprasellar cistern, cerebellum, basal cisterns, dentate nuclei, and an area adjacent to the fourth ventricle (arrows).

B, Axial noncontrast CT scan obtained 4 years earlier shows no areas of increased attenuation in the parasellar regions.

C, Sagittal noncontrast T1-weighted MR image depicts a suprasellar mass along with areas of increased signal in the tuber cinereum (black arrow) and tectal region (arrowheads), consistent with T1 shortening from melanin. Note the subtle area of increased signal in the pons (white arrow).

D, Contrast-enhanced MR image shows marked basal cistern involvement (arrows).

E, Axial contrast-enhanced T1-weighted MR image of the brain shows enhancement of the basal meninges and intraparenchymal lesions of both temporal lobes (arrows).

F, Corresponding axial FSE T2-weighted MR image shows heterogeneous signal intensity in the parasellar region with decreased signal intensity from areas of melanin (arrows).

G, Sagittal noncontrast T1-weighted MR image reveals a large, hyperintense, oblong, anterior intraspinal mass (arrows). Note subtle areas of increased signal intensity surrounding the adjacent spinal cord anteriorly and posteriorly (arrowheads).