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.¹ 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 subependymoma^1,2. 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 sclerosis¹.

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