Presentation
Ataxia
Patient Data
Age: 55 years
Gender: Male
From the case:
Epidermoid cyst – fourth ventricle
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A large abnormal signal intensity non-enhancing lesion is noted in the fourth ventricle returning low signals on T1WI, high signals on T2WI, heterogeneous dirty signals on FLAIR, and positive diffusion restriction.
Inferiorly the lesion is reaching the level of foramen magnum.
Anteriorly the lesion is compression the pons and medulla oblongata.
Posteriorly and laterally the lesion is compressing the cerebellar vermis and cerebellar hemispheres.
Superiorly the lesion reaches the level of sylvian aqueduct.
Moderate dilatation of the lateral and third ventricles is noted.
Case Discussion
The features are suggestive of a large epidermoid cyst inside the fourth ventricle causing proximal moderate triventricular hydrocephalus.
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