History of low-grade astrocytoma, status post craniotomy and chemotherapy. Off therapy for 10 years. There is again extensive susceptibility artifact along the left side of the head secondary to ventriculostomy catheters, which limits evaluation of surrounding structures. Left frontal approach ventriculostomy and additional occipital approach catheters are stable in position.There is no significant change in the configuration of the suprasellar region which is distorted including a lesion which is isointense to gray matter on T2 and hyperintense to surrounding CSF on FLAIR sequence images. This lesion measures up to 8 x 16 mm in maximum axial AP and transverse dimension which is stable within limits of technical differences (previously 10 x 16 mm). There is also an unchanged pattern of nodular enhancement associated with suprasellar structures and adjacent the optic chiasm. An index focus of enhancement near the anterior communicating artery is stable measuring 9 x 8 x 7 mm, previously 8 x 7 x7 mm. A focus of intraparenchymal enhancement closely associated with the deep aspect of a right frontal ventriculostomy tract is significantly decreased. Minimal leptomeningeal enhancement along the central sulcus is similar to prior.There is stable dysmorphic configuration of the basal cisterns, fourth ventricle and cerebral aqueduct. There are no new enhancing foci demonstrated. There is no new intracranial mass, hemorrhage or hydrocephalus.
1.No findings to suggest tumor progression. No significant change in nodular enhancement at the suprasellar cistern and cystic lesion at the level of the frontal horns. 2.Interval decrease in focus of enhancement associated with the deep aspect of a right frontal ventriculostomy tract.3.Unchanged dysmorphic appearance of the ventricular system and position of the ventriculostomy catheters. No hydrocephalus.