Diagnosis: Headache Hydrocephalus, unspecified Presence of cerebrospinal fluid drainage deviceClinical question: new weakness, h/o spina bifida s/p VP shuntsSigns and Symptoms: new weakness The patient is status post ventriculostomy tubes one coursing through the right temporal lobe into the trigone of the right lateral ventricle other one coursing through the left occipital lobe into the body of the left lateral ventricle with tip anteriorly adjacent to the frontal horn. There is a linear signal change present within the right frontal lobe which is a compatible with prior ventriculostomy tract is unchanged since the prior exam. There is a port adjacent to the left occipital catheter associated with tubing.There are periventricular T2 and FLAIR signal hyperintensities present as well as signal hyperintensities in the corpus callosum on T2 and FLAIR MRI which are stable compared to the previous exam.On susceptibility imaging imaging there is a punctate signal hyperintensity in the left centrum semiovale. Translation and is of little clinical significance. Some foci of signal hypointensity are also present along the right frontal lobe ventriculostomy tube tract.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses demonstrates mild mucosal thickening. The visualized portions of the mastoid air cells demonstrate minor opacities. The visualized portions of the orbits are intact.
1.The MRI of the brain is stable compared to the 10/23/2014 MRI brain exam. There is redemonstration of status post ventriculostomy tube placement as well as signal changes brain parenchyma which are most likely related to ventriculostomy tube tracts.