T1 coronal post gad w/fat sat T1 axial post gad T2 axial

Diagnosis: Subependymal & intraventricular hemorrhage- unknown etiology.

Intraventricular hemorrhage may be due to trauma, aneurysm, neonatal germinal matrix hemorrhage, neoplasm, coagulopathy, or arteriovenous malformation. These lesions contain methemoglobin since they have increased signal on both T1 and T2 without enhancement or change with fat sat. The fat saturation pulse sequence was performed to rule out a dermoid. MR one month later, without treatment, shows a residual focus of methemoglobin surrounded by a rim of hemosiderin.

The reason for this hemorrhage is unknown. Aneurysm is unlikely due to the location being mostly subependymal in the body of the lateral ventricle. There was no history of trauma. If there were an underlying neoplasm it would be evident one month later. A small AVM is possible, however an angiogram was not performed. Related Cases

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