Epidermoid cyst - obstructive hydrocephalus

Case contributed by Dr Ammar Haouimi

Presentation

Symptoms of raised intracranial pressure

Patient Data

Age: 30 years
Gender: Male

There is a well-circumscribed, lobulated midline cystic lesion of the posterior cerebral fossa of inhomogeneous low signal intensity on T1WI, high signal intensity on T2WI with heterogeneous/dirty signal on FLAIR sequence and restricted diffusion on DWI/ADC. Thin peripheral enhancement is noted on postcontrast sequences. This lesion shows an extension through the foramen of Magendie along the posterior aspect of the medulla and bulbomedullary junction which are mildly compressed and displaced anteriorly. The 4th ventricle is compressed and displaced anteriorly. At supratentorial level, the 3rd and lateral ventricles are markedly dilated with mild periventricular interstitial edema indicating obstructive hydrocephalus.

Case Discussion

MRI features suggestive of an epidermoid cyst of the posterior cerebral fossa with obstructive hydrocephalus

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Case information

rID: 67005
Published: 17th Mar 2019
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included
Institution: Aurès Medical Imaging Center - Batna Algeria

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