Demographics:
19 years old, Male
Indication:
Newly diagnosed hydrocephalus
Findings
CT
- Mildly hyperattenuating pineal region mass with internal calcification
- Associated obstructive hydrocephalus at the level of the cerebral aqueduct
- Right frontal approach external ventricular drain terminating in the third ventricle
- Multifocal areas of calvarial thinning, particularly involving the bilateral greater sphenoid wings and squamous temporal bones and the cribriform plate
MRI
- Avidly, somewhat heterogeneously enhancing pineal region mass measuring 2.7 x 2 x 3 cm which engulfs the pineal calcification and exerts downward mass effect on the tectum resulting in obstructive hydrocephalus
- Mild corresponding T1 signal hypointensity
- T2 signal intensity and restricted diffusion are similar to gray matter
- Left frontal approach ventricular drainage catheter
- Right mastoid effusion
Diagnosis
Germinoma (pineal region)
Key Imaging Features
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Differential Diagnosis
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Discussion
Pearls
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