Presentation
Increased head circumference with visual symptoms.
Patient Data
Large lobulated extra-axial cyst filling the suprasellar cistern and extending to the interpeduncular, prepontine and superior cerebellar cisterns as well as the medial aspect of the right middle cranial fossa. It elicits a CSF signal on all sequences with no restricted diffusion. The 3rd ventricle is compressed and displaced superiorly. The optic chiasma and pituitary stalk are compressed and displaced anteriorly. Dilatation of the lateral ventricles with no transependymal edema. The 4th ventricle is of normal size and shape.
Case Discussion
MRI features most consistent with a large suprasellar arachnoid cyst compressing and displacing the adjacent structures as well as the 3rd ventricle with biventricular obstructive hydrocephalus.
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