A 45-year-old woman presents with a several-month history of progressive headaches, visual disturbances, and personality changes. On examination, there are no focal neurological deficits, but fundoscopy reveals papilledema. Magnetic resonance imaging (MRI) of the brain shows a contrast-enhancing mass in the frontal lobe. What is the most likely diagnosis, and what is the initial step in management? A. Meningioma; perform a craniotomy for tumour resection B. Glioblastoma multiforme; initiate radiation therapy C. . Cerebral metastasis; perform a whole-brain radiation therapy D. Pseudotumor cerebri (idiopathic intracranial hypertension); prescribe acetazolamide E. Migraine with aura; initiate prophylactic migraine therapy Answer: A. Meningioma; perform a craniotomy for tumour resection Explanation: This patient's presentation with progressive headaches, visual disturbances, personality changes, and papilledema is highly suggestive of a brain tumour, likely a meningioma, which is a common benign intracranial tumour. The initial step in the management of symptomatic meningioma is surgical resection, typically via craniotomy. Glioblastoma multiforme, cerebral metastasis, and pseudotumor cerebri would have different imaging findings and management approaches. Migraine with aura is a benign condition and not the likely cause of these symptoms.
