Presentation
Headache
Patient Data
An abnormal lesion of fat signal seen behind the tectum of the midbrain. Best seen on sagittal images is chemical shift artefact (front-to-back in the frequency encoding direction) confirming that this is fat. The corpus callosum is abnormal with absent rostrum and dysgenic posterior body. There is abnormal orientation of both lateral ventricles as well as dilated occipital horns consistent callosal dysgenesis. A ventriculoperitoneal shunt is demonstrated.
Case Discussion
A patient with tectal lipoma and callosal dysgenesis first presented with hydrocephalus treated with shunting. A tectal lipoma is usually accidental findings and rarely presents with symptoms (about 20% of patients). The common symptoms are intracranial hypertension and obstructive hydrocephalus which are treated by shunting surgery.
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