Female, 49 years old, with headache, double vision and right face numbness, status post third ventriculocisternostomy. The lateral and third ventricles remain dilated without significant interval change from the prior examination. Bilateral frontal approach ventricular shunt catheters are in stable position.A small defect within the floor of the third ventricle is again seen, best appreciated on thin section sagittal images. There does appear to be a faint jet of flow related signal spanning the third ventricle and basal cistern, though it is less conspicuous than that seen on the prior examination.A thin tract of enhancement is evident along the left frontal ventriculoscopy trajectory including at the ventricular margin where there is trace hemosiderin staining and FLAIR hyperintensity. A few additional scattered foci of FLAIR hyperintensity are unchanged. No significant parenchymal edema is seen. No other enhancing lesions are detected. No findings to suggest acute intracranial hemorrhage are seen.
1.Redemonstration of findings related to bilateral frontal approach ventriculostomy catheter placement.2.Findings are also seen compatible with recent third ventriculocisternostomy. The cisternostomy defect appears to be patent and there is evidence of flow across the floor of the third ventricle, though it appears less robust than on the prior examination.3.Expected postoperative granulation is seen along the left frontal ventriculostomy tract.4.No additional specific findings are seen to account for the patient's symptoms.