Compressive arachnoid cyst with secondary intracranial hypertension

Case contributed by Dr Ammar Haouimi

Presentation

Left hemiparesis.

Patient Data

Age: 20 months
Gender: Female

The MRI sequences demonstrate a large extra-axial cystic lesion measuring (9.5 x 9 x 6.5 cm) of CSF signal on all sequences in the right middle cerebral fossa, extending to the fronto-insular region, compressing the temporal, frontal, and parietal lobes with a mass effect on the midline structures. No restricted diffusion is seen on DWI/ADC.

Prominent subarachnoid spaces around the optic nerves with mild flattening of the sclera bilaterally indicating probably secondary intracranial hypertension

Case Discussion

MRI features of a large arachnoid cyst type III according to Galassi classification of middle cranial fossa arachnoid cysts with secondary intracranial hypertension.

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