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Aqueductal stenosis with suprasellar arachnoid cyst and Blake's pouch cyst

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Had ventriculocisternostomy for obstructive hydrocephalus discovered on CT (not shown).

Patient Data

Age: 10 years
Gender: Female

Marked dilatation of the third and lateral ventricles with no evidence of periventricular transependymal oedema. The sagittal FIESTA sequence shows aqueduct stenosis (web or diaphragm).

Suprasellar and prepontine cyst of CSF signal on all sequences, displacing the third ventricle superiorly and optic chiasma and infundibulum anteriorly suggestive of an arachnoid cyst.

Moderate dilatation of the fourth ventricle communicating with infracerebellar cyst suggestive of Blake's pouch cyst.

Case Discussion

MRI features of aqueductal stenosis (web or diaphragm) with obstructive hydrocephalus, suprasellar arachnoid cyst and Blake's pouch cyst.

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