Headache. Tectal glioma and 3rd VC. Evaluate CSF flow through the fenestration and change to lesion. There has been apparent interval decrease in size and enhancement of the exophytic nodular portion of the tumor within the posterior third ventricle, which now measures 14 x 10 mm, previously 17 x 12 mm. Otherwise, there is no significant change in the ill-defined portion of the tumor within the left thalamus that contains associated susceptibility effect and intrinsic T1 hyperintensity likely related to prior hemorrhage, which measures approximately 20 x 15 mm. The third ventriculostomy appears to be patent, as evidenced by the presence of a robust traversing jet of CSF. There is no significant interval change in the degree of lateral ventricular dilatation with a right transfrontal shunt catheter in position. Likewise, effacement of the superior aspect of the cerebral aqueduct persists and the fourth ventricle appears unchanged in size. There is no evidence of acute infarction. The major cerebrovascular flow voids appears to be grossly intact. The skull, paranasal sinuses, mastoid air cells, scalp, and orbits appear unchanged.
1. Interval decrease in size and enhancement of the exophytic nodular component of the glioma within the third ventricle, but no significant change of the left thalamic portion of the tumor.2. Patent third ventriculostomy, but no significant interval change in size of the shunted lateral ventricles.