Large arachnoid cyst

Case contributed by Huda B. Gharbia
Diagnosis almost certain

Presentation

Visual disturbance, vomiting.

Patient Data

Age: 3 years
Gender: Male
mri

Large extra-axial cystic space occupying lesion in left fronto-temporal region. It appears hypointense in T1W and hyperintense in T2W images, exhibits CSF signal intensity in FLAIR sequences. It shows no restricted diffusion in DW/ADC sequences.

It causes mass effect in form of severe compression and buckling of left fronto-temporal lobes, subsequently shifting midline structures to right side (transfalcine herniation).

It is crossing midline, extends to right frontal region, and buckling the right anterior frontal lobe, obliterating the olfactory fossa on both sides and causes bone remodeling of the overlying calvarium.

Case Discussion

Large extra-axial cystic space occupying lesion extending from left middle cranial fossa to vertex, of CSF signal intensity, with no restricted diffusion, causes mass effect, transfalcine herniation, suggestive large arachnoid cyst.

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