RESUMO
Patients with epidermoid cyst of the fourth ventricle usually present with headaches and/or disequilibrium. These cysts are characterized by a focal lesion that is nearly isodense to CSF at CT and nearly isointense to CSF on T1W and T2W MR images. MRI using FLAIR and diffusion weighted images as well as 3D CISS acquisitions is useful to better characterize the lesions and their relation with the vermis, foramen magnum and CP angle cisterns. DWI images are useful for postsurgical evaluation of residual tumor. Extension of the cyst into the CP angle cisterns usually precludes complete surgical resection.
Assuntos
Encefalopatias/diagnóstico , Cisto Epidérmico/diagnóstico , Quarto Ventrículo , Adulto , Biópsia , Encefalopatias/líquido cefalorraquidiano , Encefalopatias/complicações , Encefalopatias/cirurgia , Ventriculografia Cerebral , Quimioembolização Terapêutica , Transtornos de Deglutição/etiologia , Cisto Epidérmico/líquido cefalorraquidiano , Cisto Epidérmico/complicações , Cisto Epidérmico/cirurgia , Cefaleia/etiologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Equilíbrio Postural , Transtornos de Sensação/etiologia , Tomografia Computadorizada por Raios X , Vertigem/etiologia , Distúrbios da Voz/etiologiaRESUMO
Wernicke encephalopathy (Wernicke-Korsakoff encephalopathy) is related to thiamine deficiency. We report the MRI findings in four patients with visualization of bilateral and symmetrical hyperintense foci on T2W and FLAIR images involving the periaqueductal gray matter, the mamillary bodies and around the third ventricle. Diffusion weighted images obtained in two patients demonstrated mild hypersignal in the same areas. Contrast enhancement within the mamillary bodies was noted in one patient. Follow-up MRI obtained in three patients showed rapid regression of signal abnormalities without correlation with good clinical outcome.