Case of Right Parietal SOL

Kamariah bt Zakaria
B762368

68/F

U/L DmT2

P/w left sided u/L and l/l weakness 1/52
Progressively worsening
Today completely unable to walk

Slurred speech for about a week.

Otherwise no fitting
No vomiting
No blurring of vision / diplopia

O/e full GCS
Normotensive

Neurological exam

Tone - left hypertonia
Power - left 4/5 (lower limb 3-4/5)
Reflex normal
Sensation intavt
Plantaris downgoing
No clonus

CN 1,2,3,4,5,6 intact

7 - loss of nasolabial fold. Forehead sparing.

8,9,10,11 intact

12 - tongue deviation to left.

Breast examination - left breast mass 6x5cm, mobile, firm, not fixed to skin

CT brain hypodense lesion over right parietal region with perilesional oedema compressing lateral ventricle. No midline shift.

Imp : TRO Mets

Plan
Refer surgery for triple assessment
For MRI brain
For Keppra