Presentation
Vertigo and headaches.
Patient Data
Extra-axial mass centered on the suprasellar and left crural cistern extending inferiorly to the cerebellopontine angle without intracanalicular extension as well as to the prepontine cistern.
The lesion makes pressure effect and compresses the V to VII cranial nerves.
It displays a low signal on T1, heterogeneous signal on FLAIR, and high signal on T2 with restricted diffusion and no enhancement seen on the postcontrast sequence.
Narrowing of the right internal carotid intracranial segments is seen.
Case Discussion
Historically, arachnoid cysts and intracranial epidermoid cysts were considered differential diagnoses as both followed CSF signal on CT and MRI. On modern scanners, an particularly with the advent of FLAIR and especially diffusion-weighted imaging differentiating these lesions has become trivial, and they should never be considered valid differential diagnoses.
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