Many shunt revisions, hydrocephalus, headache, stroke, yearly follow up: evaluate for changes. There are postoperative findings related to right hemispherectomy with an unchanged heterogeneous fluid collection in the right extradural space deep to the craniectomy flap that measures up to approximately 15 mm in thickness and midline shift to the right. The deformed third and lateral ventricles are not significantly changed in appearance. However, there is slight interval decrease in size of some cystic compartments in the left occipital lobe that appear to communicate with ventricular system, while other cystic compartments assocated with the ventricular system appear to be unchanged or perhaps slightly larger, although precise comparison is limited due to differences in head positioning. There is unchanged diffuse confluent cerebral white matter T2 hyperintensity in a large portion of the left hemisphere, particularly in the periventricular region. There is a left transparietal tract, but no shunt catheter is present. There is unchanged posterior deviation and areas of encephalomalacia in the upper cervical spinal cord. There is no evidence of acute intracranial hemorrhage, mass, or acute infarct. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are unchanged.
1. Chronic postoperative findings related to right hemispherectomy with no significant change in the deformed ventricular system and gliotic portions of the left cerebral hemisphere, although cyst compartments in the left cerebral hemisphere that seem to be associated with the ventricular system appear to have fluctuated slightly in size.2. Unchanged posterior deviation and areas of encephalomalacia in the upper cervical spinal cord, which may be attributable to adhesions and chronic infarction, respectively. A dedicated cervical spine MRI may be useful for further characterization.