Female, 2 years old, history of GBS meningitis with ventriculomegaly, cerebral cysts, monitor cyst post fenestration. A ventricular catheter traverses the right frontal lobe to terminate along the margin of the right lateral ventricle, grossly similar in position. Since the prior examination, a second catheter has been placed traversing through the right frontal lobe, coursing posteriorly, medially and inferiorly. This catheter traverses a dilated midline space at approximately the level of the cerebral aqueduct, ultimately terminating along the posterior margin of the fourth ventricle. Susceptibility at the catheter tip may represent an artifact or hemosiderin staining.The caliber of the frontal horns and widely splayed cavum septum pellucidum, in aggregate, has increased measuring up to 41 mm in maximum transverse dimension, previously 38 mm. Ventricular caliber at the level of the atrium has increased from 8 mm to 11 mm on the left, and decreased from 8 mm to 6 mm on the right. Caliber of the left temporal horn has also decreased. Caliber of the third ventricle has probably not changed.Numerous periventricular and choroid plexus cysts are redemonstrated. A cyst along the choroid plexus at the level of the right atrium has changed variably with one component slightly larger and another slightly smaller. A cyst along the medial right temporal lobe has not significantly changed in size. A cyst along the medial left temporal lobe has decreased in size.Dilatation through the region of the cerebral aqueduct is probably not significantly changed. Fourth ventricular cysts extending through the foramina of Luschka have not significantly changed in size.The pituitary region is unremarkable. The corpus callosum remains markedly thinned and deformed similar to prior. No restricted diffusion is seen. Scattered foci of parenchymal and ependymal susceptibility are unchanged and likely reflect sequelae of prior instrumentation and/or infection. Mild periventricular T2 hyperintense rimming also remains unchanged.
1.Interval placement of a new catheter which traverses the right frontal lobe, courses through the tentorial incisure at the level of the cerebral aqueduct, ultimately terminating in the region of the fourth ventricle. The pre-existing right frontal ventricular catheter is in stable position.2.Mild interval increase in the caliber of the ventricles at the level of the frontal horns and also at the left atrium. Ventricular caliber elsewhere is stable or decreased.3.Variably changing cysts along the choroid plexus at the level of the right atrium with some components slightly smaller and some slightly larger. The remaining cysts, including those along the temporal lobes and within the posterior fossa, are stable to smaller as discussed above.