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A 32-year-old man gave a 6-month history of intermittent generalised headaches, later lateralising to the right side, associated with occasional night sweats. Six weeks before admission he had noticed a gradual swelling in the right temporal area (figure 1). His examination was otherwise normal. He had a raised erythrocyte sedimentation rate, and a chest X-ray showed a widened mediastinum. MR scan (visit the journal online to view the video) of the brain showed a destructive lesion of …
Contributors TH: author and physician contributing to the care of the patient. TO: author and consultant physician in charge of care of patient.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed. This paper was reviewed by David Nicholl, Birmingham, UK.