White epidermoid cyst
Dizziness for around one year.
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There is a rounded T1, T2, FLAIR hyperintense lesion which is favoured to lie within the cerebellar parenchyma, although may be within the 4th ventricle. No perilesional oedema. There are several regions of diffusion restriction, with no significant contrast enhancement. The fourth ventricle is largely effaced, although no hydrocephalus is demonstrated.
The lesion is most compatible with a white epidermoid cyst. Epidermoid cysts are typically T1 isointense and FLAIR hypointense but in this case, we see T1 and FLAIR hyperintensity probably due to high protein content.