An enhancing lesion arises from the inferior 4th ventricle, distorting the medulla and displacing it anteriorly. No hydrocephalus. Rare and sparse chronic small vessel ischaemic white matter changes are present, in a number acceptable for the age group. The remainder brain is unremarkable.
Conclusion: 4th ventricle mass which may correspond to an ependymoma or a choroid plexus papilloma.