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SMA Syndrome
Joseph Junewick, MD FACR
over 9 years ago
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Case Detail

Anatomy: Brain-Spine
Heather Borders, MD
Diagnostic Category: Developmental or Congenital
Created: over 10 years ago
Updated: over 10 years ago
Tags: PEDS
Modality/Study Types: MRI
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8 year old with history of “tics” and cyst diagnosed on outside CT.

Case Images




Mildly heterogeneous hypointense T1, hyperintense T2 (not shown) extra axial cyst with associated restricted diffusion in the suprasellar region. No central enhancement.


Epidermoids develop from ectoderm; congenital rests from incomplete separation of the neuroectoderm and cutaneous ectoderm. Epidermoid is more common than dermoid.

The location of epidermoids is variable, whereas dermoids are typically midline. Most frequently these are found in the posterior fossa. Other locations include pineal, suprasellar and middle cranial fossa.

CT usually shows a low density lobulated mass in one of the above mentioned locations. Density is usually equal to CSF. MRI demonstrates a mildly heterogeneous lobulated extra axial mass with prolonged T1 and T2 relaxation times. No enhancement after contrast. Differentiation from an arachnoid cyst may be difficult, particularly when small. Diffusion weighted imaging is definitive, and will demonstrate restricted diffusion. Lesions will usually be hyperintense on FLAIR.


Barkovich: Pediatric neuroimaging. pp. 539-541.

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