brain abscess follow up The right parietal lobe ventriculostomy tube has been removed since prior exam. Instead, there is a new ventriculostomy tube inserted through the left frontal lobe. There is localized brain edema on the left frontal lobe ventriculostomy tube insertion site likely to be related to ventriculostomy tube insertion procedure.Comparing to prior scan, FLAIR high signal intensity the right parietal lobe ventriculostomy tube track appears to be a bit lessen. On Gad enhanced scan, there still is ventriculostomy tube track enhancement, however, the degree of enhancement also appears to be lessen than prior.Overall, leptomeningeal enhancement pattern appears to be bit prominent and somewhat nodular indicating meningeal irritation or inflammation. Comparing to prior exam, the pattern and degree of enhancement do not show significant interval change. The ventricles, sulci and cisterns are symmetric and unremarkable. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. Normal enhancement of pituitary gland, no change since prior exam.The paranasal sinuses and mastoid air cells are clear.
1. Interval removal of right parietal ventriculostomy tube and new ventriculostomy tube inserted through the left frontal lobe. The new ventriculostomy tube track shows edema on FLAIR images which most likely to be related to the procedure. 2. Interval decrease of left ventriculostomy tube track enhancement since prior exam.3. No significant interval change of diffuse leptomeningeal enhancement pattern.4. Normal ventricular system size.