(Idiopathic) normal pressure hydrocephalus. There are postoperative findings related to bifrontal craniotomy and three transfrontal ventriculostomy catheters. There is a right of midline frontal approach catheter with distal tip terminating in the prepontine cistern. There is a left frontal approach catheter with distal tip terminating in the third ventricle and additional left frontal approach catheter with distal tip terminating in the left lateral ventricle. There is encephalomalacia in the anterior right frontal lobe. There is prominence of the lateral and third ventricles and either a small cystic structure or adhesions present in the third ventricle. There is confluent T2 signal hyperintensity surrounding the margins of the lateral ventricles. There is also a chronic right thalamocapsular lacunar infarct. There is no midline shift. There is no evidence of acute ischemia or intracranial hemorrhage. There is no abnormal intracranial enhancement. There is thickening of the left frontal calvarium.
1. Mild prominence of the catheterized lateral and third ventricles with a small possible cystic structure or adhesions present in the third ventricle. Confluent white matter T2 hyperintensity surrounding the lateral ventricles is nonspecific.2. Encephalomalacia in the right anterior frontal lobe deep to the craniotomy site and chronic right thalamocapsular lacunar infarct.