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Ring-shaped lateral ventricular nodules: a “leave me alone” lesion

Nódulos ventriculares laterais em formato de anel: uma lesão “não me toque”

A 34-year-old female presented at our facility with headache. The MRI showed ring-shaped lateral ventricular nodules (RSLVNs) (Figure).

Figure
MRI, axial balanced, a three-dimensional steady-state free precession T2-weighted imaging (A), FLAIR (B) and T1-post gadolinium (C), obtained at the level of the roof of the lateral ventricles show ring-shaped left lateral ventricular nodules (arrows) with no contrast enhancement.

The RSLVNs are an incidental finding on MRI in patients who undergo neuroimaging mainly for headache.11. Shimono T, Hosono M, Ashikaga R, Kumano S, Imaoka Y, Okada M et al. Ring-shaped lateral ventricular nodules: an incidental finding on brain magnetic resonance imaging. Neuroradiology. 2009;51(3):145-50. https://doi.org/10.1007/s00234-008-0476-5
https://doi.org/10.1007/s00234-008-0476-...
The nature of the RSLVNs is controversial and includes neuroglial/glioependymal cyst, inflammatory or reactive formation of ependyma, astrocytic gliosis reaction near subependymal veins, redetachment of the fused portion of coarctation of the frontal horn or a variant of subependymoma11. Shimono T, Hosono M, Ashikaga R, Kumano S, Imaoka Y, Okada M et al. Ring-shaped lateral ventricular nodules: an incidental finding on brain magnetic resonance imaging. Neuroradiology. 2009;51(3):145-50. https://doi.org/10.1007/s00234-008-0476-5
https://doi.org/10.1007/s00234-008-0476-...
,22. Friedman DP. Abnormalities of the deep medullary white matter veins: MR imaging findings. AJR Am J Roentgenol. 1997;168(4):1103-8. https://doi.org/10.2214/ajr.168.4.9124123
https://doi.org/10.2214/ajr.168.4.912412...
. In the differential diagnosis, the most common pathological entities are subependymal heterotopias, usually found in patients with epilepsy and subependymal nodules in patients with tuberous sclerosis11. Shimono T, Hosono M, Ashikaga R, Kumano S, Imaoka Y, Okada M et al. Ring-shaped lateral ventricular nodules: an incidental finding on brain magnetic resonance imaging. Neuroradiology. 2009;51(3):145-50. https://doi.org/10.1007/s00234-008-0476-5
https://doi.org/10.1007/s00234-008-0476-...
.

References

  • 1
    Shimono T, Hosono M, Ashikaga R, Kumano S, Imaoka Y, Okada M et al. Ring-shaped lateral ventricular nodules: an incidental finding on brain magnetic resonance imaging. Neuroradiology. 2009;51(3):145-50. https://doi.org/10.1007/s00234-008-0476-5
    » https://doi.org/10.1007/s00234-008-0476-5
  • 2
    Friedman DP. Abnormalities of the deep medullary white matter veins: MR imaging findings. AJR Am J Roentgenol. 1997;168(4):1103-8. https://doi.org/10.2214/ajr.168.4.9124123
    » https://doi.org/10.2214/ajr.168.4.9124123

Publication Dates

  • Publication in this collection
    July 2018

History

  • Received
    10 Jan 2018
  • Reviewed
    03 Feb 2018
  • Accepted
    07 Feb 2018
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