Colloid cyst and secondary ventriculomegaly

Case contributed by Mohamed El Deen
Diagnosis almost certain

Presentation

NIDDM patient came to the ER department complaining of recurrent episodes of headache, forgetfulness, confusion and cognitive behavioral changes for 6 months. He also experienced multiple episodes of vomiting over last three months. No history of focal neurological deficits. Normal gait, speech, vision and hearing.

Patient Data

Age: 45 years old
Gender: Male

NECT scan of the brain showing a round-shaped iso-dense unilocular cyst seen at the roof of the third ventricle associated with secondary non communicating hydrocephalus of lateral ventricles most probably due to obstruction in foramen of Monro. No calcification or hemorrhage. Splayed frontal horns of lateral ventricles laterally to the cyst.

A midline round cystic space in the third ventricle with associated lateral ventriculomegaly and different signal intensity. Classic MRI findings of a colloid cyst. Transependymal edema is also seen denoting decompensated (acute) hydrocephalus. 

Case Discussion

CT and MR appearance of colloid cyst. 

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