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Age: 6

Sex: Female

Indication: Headache

Save ("V")

Case #36


Findings

  • Diffusely enhancing mass centered in the fourth ventricle measuring 5 x 4 x 3 cm with associated restricted diffusion
  • Resultant effacement of the fourth ventricle and marked dilation of the lateral ventricles, third ventricle, and cerebral aqueduct with extensive periventricular T2/FLAIR hyperintensity
  • Inferior displacement of the cerebellar tonsils into the foramen magnum with crowding of the upper cervical spinal cord
  • No evidence of acute infarct or hemorrhage


Diagnosis

  • Obstructive hydrocephalus

Sample Report

Diffusely enhancing mass centered in the fourth ventricle measuring 5 x 4 x 3 cm with associated restricted diffusion, most likely representing a medulloblastoma. Recommend total spine MRI with and without contrast to evaluate for drop metastases.

Resultant bilateral cerebellar tonsillar herniation and effacement of the fourth ventricle with severe obstructive hydrocephalus and extensive subependymal edema. Recommend urgent neurosurgical consultation.

No evidence of acute infarct or hemorrhage.


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