Mega cisterna magna differential diagnosis

Mega cisterna magna needs to be distinguished from other causes of an enlarged retrocerebellar CSF space:

Posterior fossa arachnoid cyst

Epidermoid cyst: often shows a heterogeneous/dirty signal on FLAIR and restricted diffusion

Cerebellar vermis hypoplasia

Dandy Walker malformation: vermis not intact

Blake's pouch cyst: usually a hydrocephalus is present

Pilocytic astrocytoma: if very posterior and predominantly cystic.