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Rabih Hage , MD Valérie Biousse , MD

Raised Intracranial Pressure with Obstructive Hydrocephalus from a Third Ventricle Colloid C yst. Rabih Hage , MD Valérie Biousse , MD. Fundus Photographs. Right eye. Left eye. Figure 1.

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Rabih Hage , MD Valérie Biousse , MD

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  1. RaisedIntracranial Pressure with Obstructive Hydrocephalusfrom a ThirdVentricleColloidCyst Rabih Hage, MD Valérie Biousse, MD

  2. Fundus Photographs Right eye Lefteye Figure 1 Bilateralsevereoptic nerve headedemawith normal visualacuity and enlargedblind spotsin a 24 year-man with 2 weeks of severeheadaches, suggestingincreasedintracranial pressure

  3. T1-Weighted Axial Brain MRI(withoutcontrast) Figure 2a Dilation of bothlateralventricles (yellowarrows) suggestinghydrocephalus

  4. T1-Weighted Axial Brain MRI(withoutcontrast) Figure 2b Dilation of bothlateralventricles (yellowarrows) suggestinghydrocephalus

  5. T1-Weighted Axial Brain MRI(withoutcontrast) Figure 3 There is a T1 isointenselesionwithin the thirdventricle (yellowcircle)

  6. T1-Weighted Sagittal Brain MRI(withoutcontrast) Figure 4 This midline sagittal cutdemonstratesseveralradiologicsignsof raisedintracranial pressure

  7. Signsof RaisedIntracranial Pressure:Obstructive Hydrocephalus Figure 4a Dilation of the lateralventricleswith normal sized (or evensmall) fourthventricle (yellowarrow), suggesting an obstruction at the level of the thirdventricle (foramen of Monro)

  8. Signs of RaisedIntracranial Pressure:CerebellarTonsilsHerniation Figure 4b Displacementof the cerebellartonsils (arrow) below the foramen magnum (dashedyellowline)

  9. Signs of RaisedIntracranial Pressure:Flatteningof the Pituitary Gland Figure 4c The sella has a shallowshape(yellowarrows), and the pituitaryappears flat (bluearrow)

  10. MRI Signs of RaisedIntracranial Pressure:Effacement of the SuprasellarCistern Figure 4d Effacement of the suprasellarcistern (yellowarrow)

  11. Sagittal brainMRI Showing a Mass in the ThirdVentricle Figure 5b Figure 5a T1 isointense (5a – yellowcircle) and T2 hyperintense(5b – redcircle) lesionwithin the thirdventricleand the region of the foramen of Monro, suggesting a colloidcyst

  12. Axial brainMRI Showing a Mass in the ThirdVentricle Figure 6b Figure 6a T1 isointense (6a – yellowcircle) and T2 (FLAIR sequence) hyperintense (6b – redcircle) lesionwithin the thirdventricleand the region of the foramen of Monro, suggesting a colloidcyst

  13. Final diagnosis Colloidcyst of the thirdventricleat the level of the foramen of Monro, complicatedby severeobstructive hydrocephalus and raisedintracranial pressure withheadaches and papilledema

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