Presentation
Witnessed fall. Laceration to back of head. Confusion.
Patient Data
Initial CT head demonstrates a shallow right parietal subgaleal hematoma. No associated skull fracture (bone windowing not provided). Contrecoup surface blood products in the left anterior cranial fossa / subdural space.
Additional finding of a mass in the right ventricular atrium. This is hyperdense to normal white and grey matter. Calcification along the posterior and superior margin suggestive of an expanded choroid plexus, with the normal plexus not seen separate from this lesion.
Mass located within the trigone of the right lateral ventricle, measuring approximately 32 mm in maximal dimension. The lesion has homogeneously T1w low signal and intermediate T2w signal, with solid enhancement. Marked diffusion restriction.
Case Discussion
Two significant findings in this case:
traumatic contrecoup hemorrhage in left frontal lobe
right choroid plexus mass
In this demographic, choroid plexus based lesions are typically meningiomas (derived from arachnoid cap cells within the plexus) or metastatic disease (as these are highly vascular structures and prone to hematogenous spread).
As part of the work up, no other lesions were identified on body imaging, and this lesion has remained stable across a few years of follow up - as such this is considered most likely to be a choroid plexus or intraventricular meningioma.
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