Intracranial epidermoid cyst
Headaches with cranial nerve deficits.
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The MRI sequences demonstrate an ill-defined lobulated extra-axial cystic mass, filling the prepontine and interpeduncular cisterns with upwards extension to the floor of the 3rd ventricle with mass effect on the midbrain. The mass encases the basilar artery as well the proximal segment of the posterior cerebral arteries. It appears isointense to the CSF on T1WI, T2WI, heterogeneous/dirty signal on FLAIR, and high signal on DWI (restricted diffusion). No enhancement was seen on the postcontrast sequence.
MRI appearance characteristic of an epidermoid cyst.