![]() These findings were compatible with an arachnoid cyst of the CVI. The cyst was isointense to cerebrospinal fluid on all sequences including FLAIR and DWI. The lateral ventricles were mildly dilated by the compressive effect caused by the cyst. The quadrigeminal cistern was unremarkable. The cyst was causing elevation and splaying of the fornices with mild compression of the inferior aspect of the splenium of the corpus callosum and inferior displacement of the internal cerebral veins. The study revealed an approximately 4.5 × 3.7 cm sized well demarcated, thin-walled, T2-hyperintense midline cystic lesion lying between the posterior half of lateral ventricles and above the roof of third ventricle. His neurological examination was otherwise unremarkable.īrain MRI included axial T1-weighted images and T2-weighted images in axial, sagittal and coronal planes as well as fluid attenuation inversion recovery (FLAIR) and a diffusion-weighted imaging (DWI) sequence. The purpose of this case report was to describe the radiological findings in a case of CVI arachnoid cyst and discuss its imaging differentials.Ī 68-year-old man with complaints of occasional headaches for two months prior to presentation was referred to us for magnetic resonance imaging (MRI) examination of the brain. However, at least three of these case reports recorded an improvement in the patients' symptoms following treatment of the CVI cyst, thus partially supporting its pathological nature and emphasizing the importance of its accurate diagnosis on imaging 2, 4, 5. This lack of data makes it difficult to ascertain the pathological significance of this finding and its association with patients' clinical symptoms especially in the absence of any pressure effects caused by the cyst. An arachnoid cyst involving the CVI is extremely rare with only six published case reports in the English literature and only one of them describing this finding in an adult 2- 7. Pathologies that may involve this cistern include an abnormal cystic dilatation of CVI or a true cyst in the form of arachnoid or epidermoid cyst and meningiomas. Rarely, it persists as a primitive structure in individuals older than two years of age with a prevalence of about 2-3% 2. CVI is a normal variant which can be seen in newborns and usually disappears with brain maturation by the end of the first year of life. ![]() It encloses the internal cerebral veins and posterior medial choroidal artery 1. This cistern extends anteriorly to the foramen of Monro, whereas posteriorly it opens in the cistern of the vein of Galen 2. CVI is bounded by the hippocampal commissure and corpus callosum superiorly, the tela choroidea and third ventricle inferiorly and the crus of the fornix on each side laterally 1. The cavum velum interpositum (CVI) is a potential cisternal space containing cerebrospinal fluid (CSF) formed by the fold of the pia mater (tela choroidea) during interhemispheric cleavage in relation to the development of the corpus callosum 1. ![]()
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