Abstract

An 11-year-old boy presented with sudden onset of altered consciousness following acute-onset severe headache and vomiting. Computed tomography showed hydrocephalus due to obstruction of the foramen of Monro by an isodense mass in the anterior third ventricle. Ventriculoperitoneal shunt was placed to relieve the hydrocephalus and the patient improved clinically. Magnetic resonance imaging of the brain revealed a well-defined lesion with isointense signal intensity on T1-weighted and hyperintense signal intensity on T2-weighted images. Acute, right occipital lobe and right thalamic infarction was revealed by diffusion-weighted imaging; smaller infarct was seen in the medial left occipital lobe. Imaging findings were compatible with third ventricle colloid cyst causing acute hydrocephalus and occipital lobe infarction due to central transtentorial herniation.

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