case_images: PMC4310044_01
case_images: Magnetic resonance imaging (MRI) of the brain performed at the time of symptom onset 8 years ago demonstrated a well-defined lobulated cystic lesion in the right middle cerebral peduncle close to the forth ventricle with mild mass effect to the cerebellar vermis. The lesion contained multiple thin septations (black arrow in C) and followed cerebrospinal fluid (CSF) signal in all pulse sequences (a) axial T1-weighted image, (b) axial postcontrast T1-weighted image, (c) axial T2-weighted image, (d) diffusion-weighted, (e) apparent diffusion coefficient). There is no definite enhancement or diffusion restriction. Mild edema is noted in the right middle cerebellar peduncle (white arrow in C). Single voxel proton MR spectroscopy (f) showed unremarkable concentration of N-acetylaspartate (NAA), choline (Cho), Creatine (Cr) with normal Cho/Cr ratio and Cho/NAA ratio
case_images: SNI-6-2-g001.jpg
case_images: PMC4310044_01_SNI-6-2-g001.jpg
case_images: F1
case_images: The MRI of the brain revealed a well-defined lobulated cystic lesion in the right middle cerebral peduncle close to the forth ventricle with mild mass effect to the cerebellar vermis [Figure 1]. T1-weighted image, Figure 1b: Axial postcontrast T1-weighted image, Figure 1c: Axial T2-weighted image, Figure 1d: Diffusion-weighted, Figure 1E: Apparent diffusion coefficient). There is no definite enhancement or diffusion restriction. Mild edema is noted in the right middle cerebellar peduncle (white arrow in Figure 1c). Single voxel proton magnetic resonance spectroscopy [Figure 1f] showed unremarkable concentration of N-acetylaspartate (NAA), choline (Cho), creatine (Cr) with normal Cho/Cr ratio and Cho/NAA ratio.
case_images: PMC4310044_02
case_images: PMC4310044_03
case_images: Serial annual brain magnetic resonance imaging (MRI), with representative axial T2-weighted images, has shown stability to slight increase in size of the lesion in the past 8 years. (a) MRI at the time of diagnosis, (b) Two years later, (c) Five years later, (d) Eight years later
case_images: SNI-6-2-g002.jpg
case_images: PMC4310044_03_SNI-6-2-g002.jpg
case_images: F2
case_images: Serial MRI imaging revealed no change in the size and shape of the lesion (Figure 2a: At the time of diagnosis, Figure 2b: 2 years later, Figure 2c: 5 years later, Figure 2d: 8 years later).