Female, 5 months old, with E. coli meningitis, cerebritis and ventriculitis. Assess size of subdural abscess and for residual ventricular abscess. Since the prior examination, a small left parietal craniotomy has been performed through which the previously seen left-sided extra-axial abscess has been evacuated. The collection is much smaller than that seen on the prior examination with only trace residual diffusion restricting material.There is air within the ventricular system and the right frontal approach EVD has been replaced. The catheter now takes a more medial course into the third ventricle. The ventricles remain markedly dilated, the severity of which is stable to minimally increased when compared to the immediate prior examination. The quantity of diffusion restricting debris within the ventricular system has slightly decreased.On postcontrast images, ependymal enhancement persists in the periatrial and temporal regions, similar to the prior examination. The previous rim-enhancing left parietal collection has collapsed into a small residual cavity with thick enhancement of the surrounding dura. No new enhancing lesions are seen.Marked parenchymal thinning is again seen. T2 hyperintensity within the anterior temporal lobes is unchanged. Mild periventricular T2 hyperintensity elsewhere, and a focus of abnormal signal within the right pons, are also unchanged.
1.Postoperative findings are seen compatible with evacuation of a left parietal extra-axial abscess. Only a small amount of residual diffusion restricting material is seen.2.Findings are seen compatible with endoscopic intervention and replacement of the right-sided EVD. Ventricular caliber is stable to very slightly increased relative to the prior exam.3.The quantity of diffusion restricting infectious debris within the ventricular system has decreased. Ependymal enhancement is unchanged.4.Generalized parenchymal thinning with areas of parenchymal signal abnormality are also unchanged.