Epidermoid cyst compressing the trigeminal nerve

Case contributed by Dr Ammar Haouimi

Presentation

Left trigeminal neuralgia

Patient Data

Age: 60 years
Gender: Male

The MRI sequences demonstrate an extra-axial mass of irregular margins at the left cerebellopontine angle, extending into the ipsilateral internal auditory canal (ICA), encasing the facial/vestibulocochlear nerves, and compressing the cisternal portion of the ipsilateral trigeminal nerve. It is of low signal on T1, heterogeneous signal on FLAIR and high signal on T2 with no enhancement seen on the postcontrast sequence. It appears of high signal on DWI with low ADC (restricted diffusion).

 

Case Discussion

MRI features characteristic of a cerebellopontine angle epidermoid cyst compressing the trigeminal nerve.

DWI is important to differentiate epidermoid cyst from an arachnoid cyst ( the arachnoid cyst follows the CSF signal on all sequences with no restricted diffusion).

 

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Case information

rID: 68906
Published: 19th Jun 2019
Last edited: 25th Jun 2019
Inclusion in quiz mode: Included
Institution: Aurès Medical Imaging Center - Batna Algeria

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