Subependymoma of the IVth ventricle

Case contributed by Dr Roberto Schubert


Headaches and dizziness, otherwise healthy.

Patient Data

Age: 30
Gender: Male

MRI brain

Midline mass in the inferior aspect of the 4th ventricle with hyperintense signal on T2- and iso- to slightly hypo-intense signal on T1-weighted images. No intralesional enhancement. No hydrocephalus. 


Annotated images

The mass in the inferior aspect of the 4th ventricle (dashed blue line) is slightly hyperintense to the adjacent cerebellar cortex on T2 weighted images and isointense to cerebellar cortex on T1 weighted images, without convincing evidence of enhancement. 

The patient went on to have a posterior fossa craniotomy and excision of the lesion, confirming it to be a subependymoma. Follow up was obtained 6 months later. 


Postoperative follow-up 6 months later.

No signs of residual or recurrent tumor after removal through a suboccipital craniotomy.

Case Discussion

This case exemplifies the difficulty in balancing various features pointing towards a diagnosis. The imaging features in this case are characteristic even though the age group is unusual. 

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Case information

rID: 17164
Published: 22nd Mar 2012
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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