Male, 14 years old, status post third ventriculocisternostomy, yearly follow-up examination. The left frontal approach ventricular shunt tube is in stable position terminating within the left frontal horn. The right occipital approach ventricular shunt tube is also in stable position terminating within the temporal horn.The lateral ventricles remain chronically dilated, left side more than right. Since the prior examination, the degree of ventricular dilatation has increased. For example, the left temporal horn now measures 18 mm across, previously 11 mm. The osseous cranial diameter has not significantly changed. As on the prior examination, a discrete cisternostomy defect is not appreciated within the floor of the third ventricle and there is no evidence of biphasic CSF flow spanning the third ventricle and basal cisterns. Focal narrowing or occlusion of the anterior aspect of the aqueduct of Sylvius is again seen, similar to prior.No new areas of parenchymal signal abnormality are appreciated. Mild abnormal signal and encephalomalacia affecting the left superior parietal lobule, just above the lateral ventricle, is less conspicuous than on the prior examination. No intracranial hemorrhage or any new abnormal extra axial fluid collection is seen.
1.Persistent chronic lateral ventricular dilatation, left side more than right, with moderate interval progression in the degree of dilatation.2.As on the prior examination, no evidence of any discrete ventriculocisternostomy defect is seen within the floor of the third ventricle, and biphasic CSF flow is not evident spanning the third ventricle and basal cisterns.3.Stable positioning of the bilateral ventricular shunt tubes. No additional new intracranial abnormalities..