Presentation
Ataxia and headaches.
Patient Data
MRI of the brain demonstrates a large heterogeneous mass measuring about 40 x 45 x 50 mm centered in the fourth ventricle and extending bilaterally into the foramen of luschka and making pressure effect upon medulla oblongata.
It is mostly hypointense to the adjacent cerebellum on T1 weighted images, heterogeneously hyperintense on T2, and without restricted diffusion.
There is no surrounding edema, and although the fourth ventricle is effaced, there are no features that suggest significant hydrocephalus in the provided images.
High signal foci in T2 and flair sequences at subcortical and periventricular white matter of both hemispheres depict microvascular ischemic events.
Case Discussion
Imaging features are suggestive of a posterior fossa ependymoma.
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