Presentation
Headaches for investigation.
Patient Data
In the roof of the third ventricle, just posterior to the foramen of Munro is a small (~6mm) rounded mass with low T2 signal. It is difficult to see on T1 axial images, but can be appreciated on SWI by a thin rim of low signal. On post contrast images it does not enhance and appears isointense to parenchyma.
Case Discussion
These features are characteristic of a colloid cyst. In a patient with non-specific headaches management can be difficult as attributing the headaches to the colloid cyst may not be correct. Sudden death is however a possibility from these lesions (sudden hydrocephalus? venous compromise? other?) and as such dismissing them can be foolhardy especially if they are sizable.