Large arachnoid cyst - suprasellar

Case contributed by Huda B. Gharbia
Diagnosis almost certain

Presentation

Headache

Patient Data

Age: 30 years
Gender: Female

Extra-axial large cystic space occupying lesion in suprasellar cistern, extending to middle cranial fossa laterally. It is hypointense in T1W, hyperintense in T2W, and exhibits CSF signal in FLAIR sequences. No restricted diffusion. No post-contrast enhancement.

It causes mass effect in the form of buckling both medial temporal lobes, pushing optic chiasm superiorly, and pituitary stalk anteriorly, splaying the floor of third ventricle, compressing foramen of Monro region, subsequently dilated third ventricle and both lateral ventricles.

Case Discussion

Large extra-axial cystic lesion of CSF signal intensity, in suprasellar cistern and middle cranial fossa, likely large arachnoid cyst.

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