Image of the month

Image of the Month Sanjiv Chopra, Section Editor Question: A 21-year-old previously healthy woman presented with a 1-year history of occipital headache increasing in severity over the 2 weeks before admission and accompanied by nausea, several episodes of vomiting, and lightheadedness. She denied cigarette, alcohol, and illicit drug use. Physical examination showed a young woman who was alert, oriented, with fluent speech, mild down-beating nystagmus, papilledema, increased muscle tone, upgoing planters, and slight weakness of the right upper extremity together with ataxia. Magnetic resonance images of the brain and spinal cord are shown in Figures A and B. Abdominal computerized tomography (CT) scanning was performed (Figure C). The patient underwent craniotomy and excision of the brain lesions. What is the diagnosis? Look on page 1058 for the answer and see the Gastroenterology website (http:// www.gastrojournal.org) for more information on submitting your favorite image to Image of the Month. DHIRAJ YADAV, M.D. JOHN HUGHES, M.D. C. S. PITCHUMONI, M.D. Division of Gastroenterology Department of Medicine and Preventive Community Medicine Our Lady of Mercy Medical Center New York Medical College Bronx, New York

© 2001 by the American Gastroenterological Association

0016-5085/01/$35.00 doi:10.1053/gast.2001.23108 GASTROENTEROLOGY 2001;120:788