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Gait disturbances and severe headaches.
T2 hyperintense and T1 hypointense lesion centered in right cerebellopontine angle. The lesion contains central cystic areas as well. There is avid post-contrast enhancement as demonstrated on post-contrast images. There is no diffusion restriction. The lesion appears to be arising from the roof of the fourth ventricle and exiting through the foramen of Luschka and thereafter displacing the brainstem and cerebellum. There is also mild dilatation of the ventricular system and T2/FLAIR periventricular hyperintensities suggesting raised intracranial pressure.
This case demonstrates classical findings of an ependymoma showing:
- necrotic areas
- avid post-contrast enhancement.
- tumor exiting through foramen of Luschka and Magendie
- origin from the fourth ventricle
The tumor was excised and histopathology confirmed ependymoma.