MRI
There is a rather well-defined lesion in the pineal region, measuring about 32 x 28 x 24 mm (AP.TRANS.CC), this lesion shows mixed central solid and peripheral cystic components, the central solid component shows diffusion restriction, with evidence of T1 hyperintensity in the anterior aspect of this lesion, which is not corresponding to fat, calcification or haemorrhage. This lesion seems to be inseparable from the tectum and midbrain and causes mass effect on them.
Peripherally located calcific foci and these lesions are noted.
After IV contrast administration this lesion showed heterogeneous enhancement of the solid component and the wall of the cystic component.
No evidence of hydrocephalus, with evidence of an enhancing tract extending from the frontal bone to the right lateral ventricle, representing sequela from a recent ventriculostomy.
Tiny avidly enhancing focus in the right frontal lobe is seen, which shows a blooming effect on SWI, compatible with a capillary telangiectasia. Incidental bilateral periventricular non-specific T2/FLAIR hyperintensities are noted, without mass effect or diffusion restriction.
An incidental well defined extra-axial cystic lesion in the posterior fossa is noted, measuring about 2 x 4 x 3 cm (AP.TRANS.CC), suggestive of posterior fossa arachnoid cyst.