Ependymitis granularis

Case contributed by Dr Paul Smith


Incidental (normal) finding.


Single FLAIR axial image through the frontal horns of the lateral ventricles demonstrates small triangular regions of high signal abutting the anterolateral aspect of the ventricles. This is a normal finding and represents the ependymitis granularis.

Case Discussion


Ependymitis granularis is symmetrical foci of periventricular high T2 and FLAIR signal hyperintensity anterior and lateral to the frontal horns.

They are usually small , less than 1 cm, and have a triangular morphology extending laterally from the callosal genu.


It is thought to occur secondary to either a focal breakdown of the ependymal lining with adjacent astrocytic gliosis; and into this region periependymal CSF/fluid preferentially drains.

Is it important?

Well no. Depite its name giving the sound of something that is inflamatory, and a 1926 article (J Neurol Psychopathol. October; 7 (26):117-124) that claimed it as a cause of chronic internal hydrocephalus, it is just an anatomical variant.

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Case information

rID: 10904
Published: 30th Sep 2010
Last edited: 16th Jul 2018
Inclusion in quiz mode: Included

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