The large midbrain cyst

Case contributed by Dr Nick Tarasov

Presentation

Headaches, mental confusion

Patient Data

Age: 65
Gender: Female
MRI

Thin-walled cystic lesion within a right part of the midbrain without perifocal oedema causing aqueductal compression and triventricular hydrocephalus (Vt up to 14mm), no transependymal imbibition.

Convexital arachnoid spaces narrowing.

Multiple multiform T2 hyperintense foci at the periventricular white matter.

No diffusion restriction.

Cystic signal characteristics on ADC maps due to T2 shine through effect.

Case Discussion

This big cyst located in the right midbrain can be a neuroglial cyst as well as giant dilated perivascular space, despite there is only one neurosurgical tactic - shunting surgery: 3rd ventriculocisternostomy or ventriculoperitoneal shunting.

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Case information

rID: 56197
Published: 17th Oct 2017
Last edited: 16th Jul 2018
Inclusion in quiz mode: Included

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