Demographics:
7 years old, Male
Indication:
Headache, vomiting
Findings
CT
- Hyperattenuating solid mass centered in the fourth ventricle with internal foci of calcification and relatively hypoattenuating components
- Associated obstructive hydrocephalus with subependymal edema and supratentorial sulcal crowding
- Downward displacement of the cerebellar tonsils
MRI
- Heterogeneously enhancing mass centered in the fourth ventricle and bulging through the right foramen of Luschka measuring 4.8 x 3.7 x 4 cm
- The mass is isointense to slightly hyperintense to gray matter on T2 and demonstrates internal areas of more avid T2 signal hyperintensity
- Irregular internal areas of restricted diffusion
- Internal foci of susceptibility artifact corresponding with areas of calcification on the CT
- No substantial surrounding parenchymal edema
- Decreased ventricular volume status post placement of a ventriculostomy catheter terminating in the frontal horn of the right lateral ventricle
Diagnosis
Ependymoma
Differential Diagnosis
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Pearls
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