Presentation
Headache and blurring of vision.
Patient Data
A large intraventricular complex lesion is noted epicentered along the right side of the septum pellucidum and occupying mainly the body of the right lateral ventricle. It is measuring 6 x 4.9 x 4.5 cm in maximum AP, SS and CC dimensions. It is predominately solid with multiple diffuse discrete cystic changes. It is hypointense on T1, hyperintense on T2 and FLAIR with heterogeneous post-contrast enhancement, multiple diffuse foci of blooming on SWI and evident diffusion restriction of the solid component.
It exerts deviation of the septum pellucidum towards the left side. It extends posteriorly compressing the tectum of midbrain with consequent supratentorial obstructive hydrocephalus (moderate right lateral ventricular dilatation and mild degree on the left).
Ballooning of the sella turcica with empty sella.
A small superior cerebellar arachnoid cyst is also noted.
Case Discussion
Imaging features are mostly representing central neurocytoma. Usually, it presents with hydrocephalus which is the result of the compression fo the mass lesion upon foramina of Monro. The multiple diffuse foci of blooming on SWI may represent foci of calcifications as no flow voids are noted on T2WI. The enhancing component shows evident diffusion restriction.
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