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Hyperextension Injuries Thoracic Spine
Joseph Junewick, MD FACR
over 7 years ago
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Case History

10 year old male with trauma and abnormal outside CT scan.

Case Detail

Anatomy: Brain-Spine
Heather Borders, MD
Diagnostic Category: Developmental or Congenital
Created: over 7 years ago
Updated: over 7 years ago
Tags: PEDS
Modality/Study Types: MRI
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Reveal Clinical Notes

Patient presented with an outside contrast enhanced CT with a small hyperdense nodule in the upper third ventricle.

Reveal Findings

MRI demonstrated a small hypointense T1 hyperintense T2/FLAIR cyst in the superior third ventricle without enhancement (the location is slightly posterior to the classically described colloid cyst location). Non contrast CT showed a hyperdense nodule in the upper third ventricle.

Spectroscopy was attempted but was limited due to the small size of the lesion.

Reveal Discussion

Mucin containing cyst at the anterosuperior third ventricle in the area of the foramen of monro (99% are located here). Derived from embryonic endoderm.

Differential: Glioma, SEGA, arachnoid cyst, choroid cyst

Colloid cyst may lead to acute hydrocephalus due to obstruction at the foramen of monro. However, 40-50 % are asymptomatic and incidental.

Cysts are usually 1-2 mm to 30 mm. CT demonstrates hyperdense (2/3) to iso/hypodense (1/3) lesion. No contrast enhancement/possible rim enhancement. MRI demonstrates variable T1 signal (hyperintense in 2/3 to isointense in 1/3). T2/FLAIR is variable and may be misleading. No restricted diffusion or enhancement. MRS-large peak around 2.0 due to colloid.

CT is useful for initial work up and follow up. It may be reasonable to follow small lesions with no evidence of complication. In this patient, a short term follow up scan will be obtained to evaluate for stability.

Reveal Diagnosis

Colloid Cyst

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