Epidermoid cyst (4th ventricle)

Discussion:

The typical features of an epidermoid cyst are illustrated in this case: the mass follows the CSF signal both on T1 and on T2 sequences. Dirty FLAIR signal is often seen, and the combination of restricted diffusion and T2 shine-through effect causes a bright DWI signal. The location on the fourth ventricle is not unusual.

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