This is a case report of a 21 years old female patient with first episode psychosis fulfilling the DSM 5 criteria for paranoid schizophrenia with an interesting neuro-radiological finding found during the routine neuro-radiological screening of the first episode psychosis. The finding is of a large right lateral intraventricular thin walled cyst and signs of obstruction of the foramen of Monro. The objective of this paper is to present and review the different correlates of this case in light of the theories of etiology of the included disorders. Etiology of schizophrenia has different theories including the infectious theory with relevance to viral infections such as Herpes Simples Virus and Cytomegalovirus also non-viral infections such as Toxoplasmosis. Additional findings have also suggested that increased susceptibility to multiple pathogens in schizophrenic patients, rather than a specific agent, may play a role in the development of schizophrenia. The role of these infectious agents in the etiology of schizophrenia is proposed to be disrupting the neurodevelopment of the brain during critical phases of development in genetically predisposed individuals. On the other hand, the foramen of Monro becomes clinically significant when it is obstructed causing non communicating obstruction. Stenosis of the foramen of Monro has been attributed to infectious origins particularly the TORCH infections causing inflammation and scarring in the region (Toxoplasmosis, Other agents, Rubella, Cytomegalovirus and Herpes Simples). Etiologies of obstruction of the foramen of Monro also includes congenital atresia, vascular malformations, and neoplastic processes. There are different interesting views with regards to the significance of the neuro-radiological findings in the MRI of this case. Some of these views have bases related to clinical experience of directly managing similar cases with a documented outcome related to a specific intervention whether pharmacological or neurosurgical. Other views believe particular findings are incidental with no causal relationships with supporting references as below. In the same context we discussed the overlap between the two disorders in one theoretically possible etiology pertinent to the neurodevelopment theories of both disorders which is the infectious one.