Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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Figure Caption
Axial T2WI (A), axial CE-T1WI (B), sagittal T2WI (C), and sagittal CE-T1WI (D). Multiple intra and extra-axial enhancing lesions are seen with a mass conglomerate showing a relatively low signal on T2WI (arrow in A) and solid enhancement with small avascular regions, which correspond to caseating necrosis. There is a trapped fourth ventricle due to an extra-axial fluid collection in the cisterna magna, that shows subtle linear enhancement of the wall and extends through the foramen ovale to the posterior cervical spinal canal, obstructing the Luschka foramen; cranially, the aqueduct is narrowed secondary to the qudrigeminal cistern involvement (arrows in C and D).
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