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Case #8

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Demographics: 6 years old, Female
Indication: Headache

Case #8

Findings

CT

  • Masslike area of hypoattenuation involving the dorsal pons and middle cerebellar peduncles with mass effect on the fourth ventricle
  • Mucosal thickening and fluid in the bilateral sphenoid sinuses and posterior ethmoid air cells

MRI

  • Masslike area of T2/FLAIR signal hyperintensity involving the pons, midbrain including the cerebral peduncles, left eccentric medulla, and left greater than right middle cerebellar peduncles
  • Area of relative restricted diffusion in the ventral aspect of the pons
  • The mass bulges into the prepontine cistern and at least partially encases the basilar artery
  • Associated mass effect on the fourth ventricle without overt hydrocephalus
  • No corresponding enhancement

Diagnosis

Diffuse midline glioma

Key Imaging Features

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Differential Diagnosis

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Discussion

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Pearls

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