 |  |  |
| CT post-contrast | T1 post-gad | T2 |
| | | |
| CT post-contrast | T1 post-gad | T2 |
Subependymal nodules are also known as subependymal hamartomas and are seen in up to 95% of patients with tuberous sclerosis. Most occur near the caudate nucleus and usually calcify. Up to 80% of subependymal nodules enhance. Enhancement does not indicate that there has been malignant degeneration. Subependymal giant cell astrocytomas are typically adjacent to the foramen of Monro. They will often calcify and show intense enhancement. These lesions are histologically benign; however; they may grow and cause obstructive hydrocephalus. Most patients with tuberous sclerosis also demonstrate cortical tubers which are best seen on T2 weighted images as subcortical foci of increased T2 signal. Cortical tubers generally do not enhance.
The white matter abnormalities seen in TS patients are thought to represent regions of dysplastic white matter and may be identified as bands of increased T2 signal which extend from the ventricles to the cortical surface. Many other abnormalities are seen in tuberous sclerosis, including ash leaf spots, molluscum fibrosum, shagreen skin patches, adenoma sebaceum, renal angiomyolipomas and cardiac rhabdomyomas among others.
In this case there are two lesions at the foramen of Monro compatible with subependymal giant cell astrocytomas. Scattered subependymal calcifications are also present. Two foci of increased subcortical T2 signal are present in the occipital lobes compatible with cortical tubers. There are no regions of increased white matter T2 signal in this case. Stereotactic biopsy of the right foramen of Monro lesion showed a grade 1 subependymal giant cell astrocytoma. Related Cases
 |  |  |
| Tuberous sclerosis | Cortical dysplasia | Tuberous sclerosis |