4-year-old male with recent seizure-like activity, ex-28 week premature gestation Several sequences are degraded secondary to artifact induced by the patient's ventricular shunt reservoir. Given this caveat:Redemonstrated is a right parietal approach ventriculostomy catheter which crosses the midline with its tip terminating at the lateral aspect of the left lateral ventricle, unchanged in position. There has been interval increase in size of the dysmorphic lateral ventricles. The third and the fourth ventricles are unchanged in size. Left hemispheric dysmorphism is unchanged.A previously demonstrated prominent left extra-axial fluid space which has been becoming more hypodense on CT demonstrates mid intensity on T1, hyperintensity on T2, with diffuse enhancement. This extends to also involve the tentorium and falx, as well as to a lesser extent the right hemispheric dura. Overlying this is a second area of crescentic abnormality measuring up to 6 mm in maximal depth over the parietal-occipital region which is nonenhancing, lower intensity on T1and T2 when compared to the overlying process, yet appearing hyperintense on T1 and T2 compared to CSF.Hemosiderin staining along the epididymal surface of the lateral ventricles is not as well demonstrated as previously. Redemonstrated is residual from germinal matrix hemorrhage. Previously demonstrated hemorrhagic debris in the right occipital horn as well as hemorrhagic foci within the posterior fossa are not visualized secondary to the aforementioned artifact.There is no midline shift or basal cistern effacement. Myelination within the uninvolved brain appears mature. Redemonstrated is thinning of the corpus callosum and volume loss in the white matter.Major intracranial flow voids appear present. Paranasal sinuses are completely opacified. Mastoid air cells and middle ear cavities are clear. Orbital contents are unremarkable.
1.Redemonstrated is a right parietal approach ventriculostomy catheter which crosses the midline with its tip terminating at the lateral aspect of the left lateral ventricle, unchanged in position. 2.There has been interval increase in size of the dysmorphic lateral ventricles. 3.Diffuse dural enhancement is present, especially notable along the left hemisphere, however also involving the falx, tentorium, and to a lesser extent the right hemisphere. There is a superimposed crescentic abnormality measuring up to 6 mm in maximal depth over the parietal-occipital region which is nonenhancing as described in detail above. The enhancing aspect is most likely secondary to dural reaction from changes of ventricular sizes and intracranial pressures. The nonenhancing crescentic portion most likely represents an evolving hemorrhage within the dura.