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MRI brain reveals a cystic lesion in the third ventricle with suprasellar extension. It shows homogeneous hypointense signal on T1, very bright signal on T2 and mild hyperintense signal on FLAIR. It shows smooth lobular margins.
It exerts a remarkable mass effect upon foramina of Monro with resultant moderate dilatation of both lateral ventricle and transependymal edema, reflecting active hydrocephalus. It is compressing also the pituitary gland in the sellar cavity. Normal cerebral aqueduct and 4th ventricle.