46 years Female (DOB:10/15/1969)Reason: 46y F with recent intracranial infection and edema seen surrounding VP shunt, please assess for interval changes History: headachesPROVIDER/ATTENDING NAME: MAI T PHO MAI T PHO MRI brain:The patient is status post suboccipital craniotomy as well as status post shunt with tubing coursing through the left occipital lobe and tip along the midline just above the corpus callosum. There is metal artifact present adjacent to the left parietal and occipital lobes related to the shunt system. Previously noted T2 and FLAIR signal hyperintensity adjacent to the shunt tubing within the brain parenchyma is not identified on the current exam.An old ventriculostomy tract course of the right frontal lobe into the right lateral ventricle.There is redemonstration of a developmental venous anomaly in the right cerebellar hemisphere.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses demonstrate minor opacities. The visualized portions of the mastoid air cells are clear. MRI orbits:The eyeballs are intact. No intraconal or extraconal space mass is identified. The extraocular muscles are intact. The lacrimal glands are symmetric and within normal limits in size and configuration. There is no optic nerve enhancement appreciated. The suprasellar cistern is intact .Some subperiosteal fluid adjacent to the left orbital roof remains unchanged since the prior exam. There is some associated contrast enhancement which is also stable
1.The patient is status post suboccipital craniotomy. There is no evidence for ventriculomegaly.2.The patient status post placement of shunt tube which courses through the left parietal lobe and has its tip just above the level of the corpus callosum along the midline. Previously noted interstitial edema adjacent to the shunt tubing within the brain parenchyma is not identified on the current exam suggesting interval regression of any inflammatory process associated with the shunt tubing.3.Imaging along the calvarium and surface of the brain at the entry point of the shunt tubing into the brain is obscured by metal artifact. An underlying lesion in this location would not be visible on MRI.4.Some subperiosteal fluid and inflammatory reaction adjacent to the left orbital roof remains unchanged since the prior exam.