Figure 1. Sagittal image (A) demonstrates a homogenous isointense mass in the atrium of the right lateral ventricle. The mass remains isointense on both T2 (B) and FLAIR (C). No restricted diffusion on the DWI (D) or corresponding ADC map (E). The mass demonstrates homogenous enhancement on the post contrast T1 image (F). Significant regional mass effect with compression of the ipsilateral midbrain and dilatation of both lateral ventricles consistent with obstructive hydrocephalus.
Figure 2. Post-contrast T1 image demonstrating homogenous enhancement of the mass.
Figure 3. FLAIR images demonstrate uncal compression of the ipsilateral midbrain, in particular, the tectum. Red arrows point to bilateral high signal intensity in the tegmental tracts extending to the level of the pons. Imaging appearance is most consistent with tegmental tract oedema and early stages of Wallerian degeneration from midbrain compression.