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Intraventricular simple cyst

Case contributed by Frank Gaillard
Diagnosis almost certain

Presentation

Headaches

Patient Data

Age: 25 years
mri

Space occupying cystic lesion occupying most of the right lateral ventricle with content mildly FLAIR hyperintense compared to CSF is noted. It has a thin smooth wall, without suspicious nodularity or enhancement or susceptibility. The septum pellucidum is shifted to the left by 10 mm. The choroid is displaced to the right. The right temporal horn is moderately dilated comparison to the left, suspicious of some degree of trapping. The remainder of the examination is remarkable--minimal FLAIR hyperintense foci in the white matter and within age-appropriate limits.

Conclusion: Right lateral ventricular simple appearing cystic lesion almost certainly represents an intraventricular arachnoid/neuroepithelial cyst.

Case Discussion

Intraventricular simple cysts have a predilection for this location, and often do not need any treatment. It can be challenging to establish if they are incidental findings or responsible for headaches. This patient remains well a number of years later and has not undergone surgery. 

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