16th August 2024

A 56-year-old female with a history of receptor triple-negative breast cancer on active treatment

A 56-year-old female with a history of receptor triple-negative breast cancer on active treatment presents with headache, nausea, and difficulty walking.

She reports that these symptoms have been worsening over the last few weeks, and she initially attributed them to side effects of her chemotherapy, but this has now ceased and she has continued to worsen.

She does not report any symptoms consistent with peripheral neuropathy. During history taking, you note that she is elaborate in her answers but becomes muddled and frustrated when pressed for details.

On examination, there is mild nuchal rigidity. There is bilateral past pointing and lower limb ataxia.

Which is the single imaging finding that is most likely to explain her presentation?

Select the SINGLE most appropriate option from the list below. Select ONE option only.