PMC2718099_01
Images from the case of a 43-year-old woman with sudden headache.. A. Noncontrast axial CT scan obtained on day 1 shows dense calcified masses (arrows) in the trigones of both lateral ventricles, combined with intraventricular hemorrhage in the right lateral ventricle. The right lateral ventricular mass extends to the body of the lateral ventricle.. B. Axial T1-weighted image shows that the right lateral ventricular mass is almost isointense to brain parenchyma. Intraventricular hemorrhage is also present.. C. Axial contrast-enhanced T1-weighted image(500/16) shows intense enhancement of the right lateral ventricular mass. The left lateral ventricular mass (not shown) exhibited inhomogeneous enhancement.. D. Axial T2-weighted image(2500/80) reveals the presence of an inhomogeneous mass in the right lateral ventricle. The low signal intensity suggets the presence of calcification and hemorrhage.. E. Angiogram of the right internal carotid artery obtained on day 3 demonstrates a hypervascular mass fed from the right anterior choroidal artery (arrows).
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An initial CT scan (Fig. 1A) showed a well-defined, dense, calcified mass, combined with intraventricular hemorrhage in the trigone of the right lateral ventricle, and another dense calcified mass was present in the trigone of the left lateral ventricle. T1-weighted MR images (Figs. 1B and 1C) obtained on the same day, the mass in the right lateral ventricle was seen as almost iso intense relative to the brain, and after the infusion of contrast material, intense enhancement was observed. The mass in the left lateral ventricle demonstrated inhomogeneous signal intensity on T1-weighted images, with less intense enhancement, and there was intraventricular hemorrhaging. On T2-weighted images (Fig. 1D), the right lateral ventricular mass demonstrated inhomogeneous low signal intensity and the left lateral ventricular mass also showed low signal intensity. Cerebral angiography (Fig. 1E) was performed two days after hemorrhaging.