17 years, Female, right frontal intraventricular mass, status post ETV, tumor biopsy, and placement of EVD. Postoperative CT reveals potential increased size of intraventricular mass. Compared to MRI brain from 11/8/2015, interval postsurgical changes of biopsy of enhancing mass involving the right lateral ventricle with interval development of hemorrhage within the tumor. Blood products are also noted layering within the bilateral lateral ventricles, third ventricle, and the suprasellar cistern as seen on recent CT. Again seen are two left transfrontal ventriculostomy catheters coursing through the bilateral frontal horns and terminating near the foramen of Monro bilaterally. The right lateral ventricle remains dilated with the septum pellucidum deviated to the left. There is mild edema and hemorrhage along the ventriculostomy catheters, particularly the more anterior/right frontal horn one. No evidence of acute infarct. No hemorrhage elsewhere in the brain. Evidence of endoscopic third ventriculostomy, patency of which can be better assessed with a high-resolution 3-D T2 and phase contrast/CSF flow sequence. No midline shift or herniation. Trace mucosal thickening involving the paranasal sinuses.
1. Compared to prior MRI from 11/8/2015 interval postsurgical changes of biopsy of enhancing intraventricular mass with development of intratumoral hemorrhage. Increased local mass effect associated with the hemorrhage results in leftward deviation of the septum pellucidum. Blood products are also noted within the lateral and third ventricles as well as the suprasellar cistern.2. Two EVD catheters are in place coursing through the bilateral frontal horns. The right lateral ventricle remains dilated as seen on CT from 11/9/2015, while the left lateral ventricle is decompressed. Third ventriculostomy has been performed, patency of which can be better assessed with a high-resolution 3D T2 and phase contrast/CSF flow sequences.