Quadrigeminal cistern lipomas make up approximately 25% of intracranial lipomas and are located within the quadrigeminal cistern. They may be associated with hypoplasia of the inferior colliculus or agenesis of the corpus callosum.
They are usually asymptomatic and are usually found incidentally. Rarely do they cause mass effect resulting in seizures or hydrocephalus 7.
CT and MRI findings are characteristic for a fat containing mass or lesion, however located in the quadrigeminal cistern.
CT demonstrates a lobulated, non-enhancing fat density mass in the quadrigeminal cistern. Peripheral calcifications can be present in some cases.
MRI reveal signal characteristic of fat:
- T1: high signal intensity
- T2: high signal intensity
- T1 C+ (Gd): no enhancement
- Fat saturated sequences: low signal intensity
Treatment and prognosis
Lipomas in general are mostly asymptomatic. If the mass results in mass effect and causes seizures or hydrocephalus, then surgical management can be considered 4,6-7.
Differentials specific to its location (quadrigeminal palate) include tectal plate glioma or mass, tectal plate cyst, arachnoid cyst, dermoid cyst and epidermoid cyst 7.
Please refer to the generic article on intracranial lipomas for further discussion.
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- 7. Ogbole G, Kazaure I, Anas I. Quadrigeminal plate cistern lipoma. (2009) BMJ case reports. doi:10.1136/bcr.07.2009.2110 - Pubmed