患者女,43岁。2年前无明显诱因出现间断性头疼、头晕,伴恶心、呕吐,呕吐后症状可缓解,无发热、肢体活动障碍等。7天前上述症状明显加重。体检:右侧巴彬斯基征阳性。MRI:四脑室内及中脑导水管区团片状不均匀长T1、长T2信号(图1、2)。其中四脑室前份靠近脑干处及中脑导水管区域见片状及团块状稍长T1信号灶,中脑导水管区稍长T1信号灶,大小约为15 mm×15 mm×16 mm(图3)。幕上 Female patient, 43 years old. 2 years ago no obvious incentive intermittent headache, dizziness, with nausea, vomiting, vomiting, symptoms can be relieved, no fever, physical activity disorders. 7 days ago, the symptoms were significantly worse. Physical examination: Right Babinski sign positive. MRI: Non-uniform patchy T1 and T2 long T2 signals in the fourth cerebral ventricle and middle cerebral aqueduct (Fig. The front of the fourth ventricle near the brainstem and the midbrain aqueduct area see flaky and lumpy slightly longer T1 signal, the midbrain aqueduct slightly longer T1 signal, the size of about 15mm × 15mm × 16mm (image 3). The curtain