The patient was a 47-year-old female who presented to the emergency department with acute headache and nausea/vomiting. She did not mention any previous history of severe headache or vomiting. On the neurologic examination papilledema was noted. There were no focal neurological deficits. She was dizzy but conscious and her Glasgow coma scale (GCS) score was 13. Computed tomography (CT) scan of the brain revealed enlargement of lateral ventricles and a well-circumscribed hyperdense mass on the roof of the third ventricle at the location of foramen of Monro (). On MRI examination, a hyperintense rim was seen around lateral ventricle on FLAIR sequence that was compatible with interstitial edema and acute nature of hydrocephaly (). A T2-hypointese (), T1-isointense mass was seen on the roof of the third ventricle (). The characteristic location and MRI signal intensity were consistent with colloid cyst. Blooming artifact was visible on susceptibility weighted sequence () and suggested the hemorrhagic nature of the lesion and explained the occurrence of acute hydrocephaly.\nThe patient underwent ventriculostomy followed by craniotomy and tumor resection and experienced an uneventful recovery. Histological examination confirmed the diagnosis of hemorrhagic colloid cyst.
Interestingly, an 11-year-old girl with a long history of headache was referred to undergoing a brain MRI. The MRI was performed with 1.5 Tesla Siemens machine.\nA well-defined rounded abnormal signal intensity lesion was visualized at the foramen of Monro resulting in moderate acute hydrocephalus. The lesion was isointense to gray matter on T2WI and hyperintense on T1WI and FLAIR images. No drop of the signal was visualized in T2 GRE sequence to suggest intralesional hemorrhage. No diffusion restriction was noted. Subtle enhancement of the lesion was seen on postcontrast images (Figures and ).\nThe first case did not receive any surgical treatment and, after ten months of follow-up, he claimed that the symptoms have diminished. The second case was lost of follow-up.