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Joseph Junewick, MD FACR
over 11 years ago
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Case Detail

Anatomy: Brain-Spine
Joseph Junewick, MD FACR
Diagnostic Category: Neoplasia Malignant
Created: over 10 years ago
Updated: over 10 years ago
Tags: PEDS
Modality/Study Types: MR
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13 month old female with vomiting.

Case Images




MR – Axial T2 and T2-FLAIR and coronal and sagittal postgadolinium T1 images demonstrate a heterogeneous 4th ventricular mass extending through the left foramen of Luschka and foramen magnum into the cervical canal.


Ependymomas develop from differentiated ependymal cells that line the ventricular system (more than half arise from the 4th ventricle). Ependymomas can occur at any age but approximately one-third arise in children less than 3 years of age.

Since these tumor are largely of ventricular origin, symptoms are usually related to cerebrospinal fluid obstruction and intracranial hypertension. Posterior fossa symptoms (ataxia and paresis) and supratentorial symptoms (seizure and focal deficits) may also be evident depending upon site of origin.

Ependymomas are circumscribed masses which extend along the CSF pathways. Relatively heterogeneous imaging characteristics reflect calcification, hemorrhage and cystic changes which are often present.


Koeller KK and Sandberg GD. Cerebral intraventricular neoplasms: Radiologic-pathologic correlation. Radiographics (2002); 22(6):1473-1505.

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