PMC5180433_01
T2-weighted (a), fluid-attenuated inversion recovery (b) axial images, sagittal MP-RAGE (c) shows enlarged fourth ventricle with dilated temporal horns of bilateral lateral ventricle. There is no suspicion of any cystic lesion except for an appreciation of a dot which turns out to be scolex. The cystic lesion with eccentric scolex is easily appreciated on constructive interference in steady state sequence (d, e, f)
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F1
The MRI was reviewed due to a high index of clinical suspicion, and the possibility of a very tiny nodule in the fourth ventricle was raised, which necessitated further imaging with with constructive interference in steady state (CISS) sequence [Figure 1].
Post-shunt follow-up magnetic resonance imaging showing asymmetric enlargement of left lateral ventricle with a cystic lesion in left foramen of monro causing obstruction (a, b). The lesion with scolex is again better appreciated on constructive interference steady state sequence (c, d)
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F2
Repeat MRI with CISS sequence was done which showed an intraventricular cystic lesion in the 3rd ventricle which was extending through the foramen of monro into the frontal horn of the left lateral ventricle with dilated left lateral ventricle [Figure 2].