Suprasellar arachnoid cyst
Gradually decreasing vision and headaches.
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There is CSF-signal enlargement of the interpeduncular cistern with mass effect on the optic chiasm, both optic tracts and pituitary stalk. The collection follows CSF in all sequences. The third ventricle is unremarkable. No hydrocephalus.There is no susceptibility artefact to suggest blood products related to trauma. No diffusion restriction identified. No abnormal contrast enhancement.
Suprasellar arachnoid cysts are benign developmental congenital collections of cerebrospinal fluid and constitute ~9% of all arachnoid cysts.
This patient has no displaced floor of the third ventricle or hydrocephalus.
Neurological and ophthalmic examination and further MR-control are indicated for this situation at the current time.
Differential diagnosis includes: cystic craniopharyngioma (adamantinomatous type - less likely due to the lack of a high protein content/machinery oil, and the absence of solid components and calcification); Rathke's cleft cyst (the majority is completely or mostly intrasellar) and neurocysticercosis (vesicular stage - no cyst with dot sign, lack of other lesions).