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A lobulated 14 x 8 mm pineal cyst projects anteriorly to obstruct the upper margin of the cerebral aqueduct, with mild to moderate hydrocephalus and mild periventricular (transependymal) signal abnormality.
Several small T2 hyperintense lesions, measuring up to 5 mm diameter inferiorly in the right pre-central gyrus, are in keeping with chronic small vessel ischaemic change, a little greater than expected for the patient's age, with no associated diffusion restriction or magnetic susceptibility. The remainder of the study is unremarkable.