 There is a suggestion of increased soft tissue density anterior to the interpeduncular cistern and extending leftward. Previous MRI from September demonstrated a suggestion of leptomeningeal enhancement at the level of the interpeduncular cistern, thus this may represent progression of cisternal leptomeningeal disease at this level, perhaps involving the left third cranial nerve.Redemonstrated is a right transfrontal ventriculostomy cathter that terminates in the expected region of the right foramen of Monro, unchanged in position. The ventricular system configuration remains unchanged. There is unchanged moderate cerebral white matter hypoattenuation, which may be treatment related. The gray-white matter differentiation is preserved. There is no mass effect, midline shift, or acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. Previously described mild bulging of the anterior optic nerves bilaterally is not well demonstrated on this study.
1.There is a suggestion of increased soft tissue density anterior to the interpeduncular cistern and extending leftward. Previous MRI from September demonstrated a suggestion of leptomeningeal enhancement at the level of the interpeduncular cistern, thus this may represent progression of cisternal leptomeningeal disease, perhaps involving the left third cranial nerve. This could be better characterized, and/or confirmed, by gadolinium enhanced brain MRI.2.The remainder the study is unchanged.