Presentation
Seizures.
Patient Data
Age: 10 years
Gender: Female
From the case:
Choroidal fissure cyst
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Small well-defined ovoid cystic lesion of the left choroidal fissure of homogeneous low signal on T1 and FLAIR and high signal on T2 with no restricted diffusion (CSF signal). Moderate mass effect is noted on the hippocampus.
Case Discussion
MRI feature most consistent with choroidal fissure cyst.
Choroidal fissure cysts are usually asymptomatic and discovered incidentally. They may cause seizures due to mass effect on the temporal lobe.
On imaging, the main differential diagnoses include:
solitary enlarged perivascular space (if intra-axial location)
hippocampal sulcus remnant cysts: small cystic spaces (1-2 mm) of CSF signal on all sequences, located between the dentate gyrus and the cornu ammonis.
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