On MRI, pilocytic astrocytomas are typically cystic (hypointense or isointense on T1 sequences and hyperintense on T2 weighted images with suppression on FLAIR images) and have an enhancing mural nodule.

They occur more frequently in the posterior fossa at the level of the cerebellum in young patients. In adult patients, or patients with NF1 they occur more frequently in the supratentorial compartment.

In this patient, there is a cystic mass that shows findings suggestive of a pilocytic astrocytoma. This was confirmed with histopathology following surgical resection.