Intracranial epidermoid cyst
Present with headache on a background of previous MVA. Incidental finding of intracranial eipdermoid cyst
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A 4 x 5 cm heterogeneous lesion with well defined border is located at right frontal lobe close to midline. The lesion is showing low signal on T1 high signal on T2 with incomplete attenuation on FLAIR. There is some intrinsic high signal streak best seen on T1. There are is no enhancement of the lesion after admission of the contrast. On diffusion weighed imaging (DWI) it demonstrates vivid restricted diffusion (cf. CSF).
The lesion wraps around the A1 on the right and displaces the optic chiasm towards the left (best seen on coronal T2).
This case demonstrates characteristic appearances of an epidermoid cyst. The cyst hasn't been resected yet; stable over a number of years.