Teaching Case

History of headaches.

MRI shows soft tissue, isointense with the signal of the brain tissue, localised in the posteromedial aspect of the right hemisphere, behind the thalamus and posteroinferior to the splenium of the corpus callosum, cross the midline, and protrudes into the supracerebellar cistern. No abnormal signal, enhancement or restricted diffusion (not shown) are detected.

The cingulate gyrus is localised in the medial aspect of the brain hemisphere, its caudal aspect is called isthmus, it is behind and inferior to the thalamus and bellow the splenium of the corpus callosum [2].
Large cingulate gyrus is a rare variant. If present, it could be mistaken for a mass or tumour, in that case the absence of abnormal signal on Flair or abnormal enhancement could help in the correct diagnosis [1].
Four types are described, from the most common to the most unusual, as follows: normal presentation, prominent (does not reach the midline), very prominent (reaches the midline) and large (crosses the midline), the large type usually protrudes into the superior cerebellar cistern [1].