Tectal plate lipoma
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A focal region of fat is demonstrated in the quadrigeminal (tectal plate) cistern consistent with a lipoma.
Lipomas are easily identified on CT provided they are not mistaken for CSF or air.. this depends on the window / level settings. They will have a density measurement of -20 to -100 HU (depending on size / partial voluming) rather than CSF = 0HU and air < -800HU (again depending on size / partial voluming) - a vacuum should have a measurement of -1024HU.