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Midline Posterior Fossa Extraaxial Cystic Lesions
A 9-year-old boy presenting with headaches and nausea. Ax, axial; Sag, sagittal.
An 18-year-old woman with a history of occipital surgery in early childhood now presenting with chronic daily headaches. Ax, axial; Sag, sagittal.
A 10-year-old boy with history of developmental delay. Sag, sagittal.
Magnetic resonance imaging of a fetus in the twenty-third week of gestation. Ax, axial; Sag, sagittal.
DESCRIPTION OF FINDINGS
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Case A: A prominent extraaxial space is noted posterior/inferior to the vermis and the left cerebellar hemisphere without evidence of mass effect. A normal-sized posterior fossa, vermis, and cerebellum are noted.
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Case B: A large, oval-shaped, CSF isointense, extraaxial cystic lesion is noted along with mass effect on the posterior aspect of an otherwise normal-sized vermis/cerebellum.
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Case C: A prominent midline, posterior fossa, CSF isointense, cystic-appearing lesion is noted posterior and inferior to the cerebellar vermis. Close inspection along the inferior aspect of the vermis demonstrates enhancing choroid plexus posteriorly displaced into the cyst.
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Case D: A prominent cystic dilation of the fourth ventricle is noted in conjunction with a markedly enlarged posterior fossa and absent cerebellar vermis.
Diagnosis
Case A
Mega cisterna magna
Case B
Arachnoid cyst
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