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Colloid cyst of the 3rd ventricle

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

A VP shunt was inserted 5 years ago for obstructive hydrocephalus then surgery (partially aspirated ?) 1 year later. Follow-up MRI.

Patient Data

Age: 35 years
Gender: Male

Small well-defined ovoid lesion (15 mm) is noted at the roof of the 3rd ventricle, obstructing mainly the left foramen of Monro with dilatation of the lateral ventricle (obstructive hydrocephalus). It displays a high signal on T1, low signal on T2, FLAIR and T2* with peripheral rim enhancement (usually this represents an enhancement of the adjacent and stretched septal veins).

The tip of the ventriculoperitoneal (VP) shunt is well-visualized at the trigone of the right lateral ventricle.

Focal atrophy of the genu of the corpus callosum with adjacent area frontal gliosis (probably sequelae of the transcallosal approach).

Case Discussion

MRI features of a colloid cyst of the 3rd ventricle causing an obstructive hydrocephalus.

No surgical report available, but it seems that the content of the cyst was too viscous ( low signal on T2 sequences) for that it could not be completely aspirated.

 

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