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Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery
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White epidermoid cyst of brainstem
Aneree Nilesh Shah1, Kewal Sanjay Shah2, Shilpa Sankhe3
1Radiology, King Edward Memorial Hospital and Seth Gordhandas Sunderdas Medical College, Mumbai, Maharashtra, India anereeshah1993@gmail.com.
BMJ Case Reports
|December 15, 2024
Summary
White epidermoid cysts are rare brainstem tumors. Advanced MRI and diffusion tensor imaging (DTI) helped diagnose this specific intracranial lesion, confirming it as a white epidermoid cyst.
Area of Science:
- Neuroimaging
- Neurosurgery
- Pathology
Background:
- White epidermoid cysts are rare intracranial lesions.
- Their brainstem location presents diagnostic and therapeutic challenges.
Observation:
- A bilobed intra-axial lesion with heterogeneous signal intensities on MRI was observed.
- Diffusion tensor imaging (DTI) revealed splaying of corticospinal tracts.
Findings:
- The lesion was confirmed to be cystic during surgery.
- Biopsy results identified the lesion as a white epidermoid cyst.
Implications:
- Advanced MRI techniques like DTI are crucial for differentiating brainstem lesions.
- Accurate diagnosis is essential for appropriate neurosurgical management.
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