4 4 year-old male with history of intraventricular hemorrhage with hydrocephalus, status post shunt placement, ex-28 week premature gestation, experiencing new seizure As before, 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 no interval change in size of the dysmorphic lateral ventricles when compared to the most recent CT. The third and the fourth ventricles remain unchanged in size. Left hemispheric dysmorphism is unchanged.A previously demonstrated prominent left extra-axial fluid space redemonstrates 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. These sizes, morphologies, and characteristics are stable.Hemosiderin staining along the epididymal surface of the lateral ventricles is unchanged. Redemonstrated is residua from germinal matrix hemorrhage. 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. Previously demonstrated complete opacification of the paranasal sinuses has nearly resolved. 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 no interval change in size of the dysmorphic lateral ventricles when compared to the most recent CT.3.Stable multiple intracranial abnormalities as described in detail above.