Presentation
Presented with fall and vomiting >24 hours. No focal neurological deficit.
Patient Data
Large intraventricular mass (max 50 mm), centered on the posterior part of the septum pellucidum. This has densely calcified margins, with heterogeneous density content and very faint internal enhancement following contrast.
The tectal plate is displaced inferiorly from this, with some narrowing of the cerebral aqueduct, but no frank hydrocephalus. Some entrapment of trigonal and temporal horn CSF.
No bleed or other acute findings.
Heterogeneous T1w and T2w appearances, with internal cystic content. Thick marginal calcification again shown. More enhancement appreciated following Gadolinium based contrast. No abnormal diffusion outwith the calcified components. As well as the tectal plate displacement, the inferior cerebral veins are inferiorly displaced by the mass, with the choroid plexuses and the pineal gland separate from this lesion. Some thinning of the posterior callosal body and splenium. Small volume signal abnormality above the left ventricular atrium, but no significant edema for the size of the mass.
Case Discussion
The location and appearance of this mass are typical for central neurocytoma. This has remained stable over a few years of clinical and radiological follow up.
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