 Again seen is enlargement of the lateral ventricles, particularly the left greater than right atria and occipital horns. There is thinning of the overlying periventricular white matter without significant gliosis or edema. There is mild prominence of the temporal horns, third ventricle, and fourth ventricle and unchanged. There are several scattered foci of T2/FLAIR hyperintensity in the periventricular and subcortical white matter which are similar to prior and may represent prior ischemia, inflammation, or other injury.Unchanged expansile CSF intensity involving the pineal cistern which appears to communicate with the third ventricle. The cystic space measures approximately 23 x 12 x 14 mm (APxTRVxCC) which is not significantly changed allowing for slight differences in imaging plane and slice selection.There is no evidence of acute infarct, hemorrhage, suspicious mass or new mass effect. No midline shift or herniation. Major flow-voids are patent. Bone marrow signal and extracranial soft tissues are grossly unremarkable.
1. Unchanged mild chronic ventriculomegaly, primarily involving the trigone and occipital horn of the left lateral ventricle. 2. Unchanged cystic expansion of the pineal cistern which appears to communicate with the third ventricle and may represent an arachnoid cyst. There is minimal if any local mass effect.