Findings
- Multilobulated CSF attenuation collection centered on the right sylvian fissure which communicates with a similar-appearing collection in the suprasellar cistern extending into the left sylvian fissure. Additional similar CSF attenuation collections in the perimesencephalic and left cerebellopontine angle cisterns
- Nodular calcification in the left sylvian fissure and punctate calcification along the posterior margin of the third ventricle
- Enlargement of the lateral and third ventricles; however the fourth ventricle is normal in size
- Diffuse mass effect with generalized cerebral sulcal effacement
Diagnosis
Racemose neurocysticercosis
Sample Report
Multilobulated CSF attenuation collections centered in the subarachnoid spaces, the largest of which is centered in the right sylvian fissure. Given associated calcification in the left sylvian fissure and posterior margin of the third ventricle, this appearance is particularly suggestive of the racemose variant of neurocysticercosis. Consider brain MRI with and without contrast for further evaluation.
Enlargement of the lateral and third ventricles; however the fourth ventricle is normal in size. Findings are concerning for developing hydrocephalus possibly related to inflammatory aqueductal stenosis.
Associated intracranial mass effect with generalized cerebral sulcal effacement. No midline shift or evidence of herniation.
No acute hemorrhage.
Discussion