History of Headache

Case History: 40-year-old with history of headache.

Figure 1. T1W image shows low signal intensity mass in septum pellucidum.

Figure 2. DWI images show restricted diffusion.

Figure 3. DWI images show restricted diffusion.

Figure 4. FLAIR images show hyperintense mass septum pellucidum.

Figure 5. T1 contrast image show enhancement in septum pellucidum mass.

The majority of intracranial ependymomas (60%) are located in the posterior fossa (infratentorial), usually arising from the floor of the fourth ventricle.

Intraparenchymal lesions (usually supratentorial) are usually large and also variable in appearance, ranging from completely solid enhancing masses to cysts with a mural nodule or more heterogeneous masses.

MRI, brain T1: Solid portions of ependymoma typically are isointense to hypointense relative to white matter.

They account for 3%-9% of all neuroepithelial neoplasms.

Although they can occur at any age, the posterior fossa tumors tend to present more commonly in the pediatric age group (mean age at diagnosis is 6 years of age).

Ependymomas are glial tumors with ependymal differentiation.

Prognosis is, however, relatively poor, mainly due to tumors occurring in surgically challenging locations, making complete resection difficult. 

General imaging differential considerations include medulloblastoma and subependymoma.

Imaging differential considerations also include choroid plexus metastasis, glioblastoma, and central neurocytoma.