A 40-year-old woman from Bolivia, with no previous medical history presented to the emergency department with severe headache, nausea and vomiting, without fever. Physical examination only revealed limited upward gaze.

Brain magnetic resonance imaging (MRI) revealed multiloculated cysts within the basal cistern, extending to the left sylvian valley with post injection enhancement of the cyst walls, exerting mass effect on the brainstem and the optic chiasm (Fig. 1A, B, D, E). Notably, contrast