44-year-old woman with history of aqueduct stenosis and hydrocephalus. The lateral and third ventricles are enlarged measuring 54 and 14 mm respectively, stable in size compared to examination from November 2015. A focal stenosis of the cerebral aqueduct is again seen inferiorly (801/56). There is no visualized CSF flow through the cerebral aqueduct. There is CSF flow through the third ventriculostomy. There is no restricted diffusion to suggest acute ischemia. No intracranial hemorrhage. No intracranial mass or mass-effect. A few foci of T2/FLAIR hyperintensity are seen in the periventricular white matter, which are nonspecific, but probably related to chronic small vessel ischemic changes. Punctate foci of susceptibility artifact in the lateral ventricular wall likely represent hemosiderin deposition from prior procedures.Sella and orbits are grossly within normal limits. There are left maxillary mucosal retention cyst, otherwise the paranasal sinuses and mastoid cells are clear. Bone marrow signal and extracranial soft tissues are within normal limits.
1.Patent third ventriculostomy. 2.Findings compatible with cerebral aqueduct stenosis with no CSF flow visualized across the aqueduct.3.Stable lateral and third ventricular size.