Clinical question: Evaluate post op, EVD clumped. Signs and symptoms: postop CT of brain without contrast:Expected postoperative changes of left suboccipital craniectomy.There is evidence of residual low density mass along the medial aspect of the left middle cranial fossa. There is evidence of hemorrhage within the expected location of more dorsal aspect of this tumor which was noted to project over the left petroclinoid ligament into the left cerebellopontine angle. There is also a small hematoma measuring approximately 10 mm times 10-mm which projects over the left cerebral peduncle and left aspect of the pons. I cannot entirely exclude the possibility of hemorrhage within the brain parenchyma however this hemorrhage may be within the residual component of tumor in the left cerebellopontine angle. Further evaluation with an MRI is recommended. There is evidence of residual blood within the prepontine cistern. There is suggestion of edema of the left cerebral peduncle.The fourth ventricle remains patent and no cerebellar abnormalities detectedThere is evidence of blood within the dependent portion of lateral ventricles and right frontal horn. In comparison with the prior examination there is no evidence of change in the above-described findings.There is a slight dilation of the supratentorial ventricular system which also remains stable since prior study.Expected postoperative changes of air within the intracranial space in bifrontal region with minimal interval decrease.
1.No detectable interval change since prior study of areas of hemorrhage or ventricular size.2.Approximately 10 mm hematoma may be within the residual component of tumor in the right cerebellopontine angle however possibility of hemorrhage within the left cerebral peduncle and pons cannot be ruled out. Further evaluation with an MRI is recommended.3.Residual low density and nonhemorrhagic tumor along the medial aspect of the left meconium fossa.