Thursday, October 08, 2009

Intraventricular Epidermoid-MRI

Epidermoids represent 0.2-1% of all intracranial masses. They arise from inclusion of epithelial remnants trapped during 3-5 weeks of fetal life (remember that choroid plexus are also formed from invagination of ectodermal tissues).
Intraventricular epidermoids are more in 4th ventricle followed by lateral ventricles.
More common in middle age; very rare in children
If ruptured, aseptic meningitis occurs.
Long T1 and T2 are due to keratin in solid crystalline state. Epidermoids have restricted ADC and complex FLAIR signal, unlike arachnoid cysts.
An expansive intraventricular lesion in lateral ventricle, iso-intense on T1-weighted image and hypo-intense on T2-weighted image with few cystic areas, demonstrating restricted diffusion suggestive of INTRAVENTRICULAR EPIDERMOID. Differential diagnosis includes Intraventricular Neurocytoma and Oligodendrogliomas but calcification is hallmark for their diagnosis. Case by- Teleradiology Providers

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