Presentation
Dull headache for few months.
Patient Data
There is a lobulated well-defined heterogeneous mainly hyperdense lesion seen occupying the atrium of the left lateral ventricle.
No intracranial hemorrhage is seen.
The rest of ventricles and subarachnoid spaces appear normal in size, shape, and position.
No shift of midline structures.
No cerebellar tonsillar herniation.
There is a lobulated well-defined lesion in the atrium of the left lateral ventricle, which appears isointense to grey matter on T1 and iso to hypointense on T2 with minimal surrounding peritrigonal edema.
Post-contrast administration shows vivid homogenous enhancement.
No hydrocephalus.
Case Discussion
As seen in this patient with a typical appearance and location of an intraventricular meningioma, which appears as a relatively hyperdense lesion on CT scan and on MRI, it appears solid, iso to hypointense on T1 and T2 sequences, with vivid homogeneous post-contrast enhancement, a confident diagnosis was given.
The neurological consultation reached a consensus decision to follow up on this patient for a longer term and evaluate the development of obstructive hydrocephalus, progression of perilesional edema, or significant growth in tumor size. If the appearance remains stable under close surveillance, no surgical intervention is warranted.
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