Clinical question: 62-year-old female with SLL, history of subdural bleed with midline shift, now with hypertension and bradycardia, concern for elevated intracranial pressure. Signs and symptoms: Bradycardia, hypertension Non-infused CT of brain:Redemonstration of periventricular low attenuation in bifrontal lobes. In comparison to the prior examination there is suggestion of interval increase of this finding.Also new since prior examination is large area of low attenuation involving the left occipital lobe surrounding the occipital horn of left lateral ventricle. Also note is made of interval increase in the size of the supratentorial ventricles. There is no evidence of hemorrhage. I believe the above findings may represent transependymal exudate secondary to gradually increasing hydrocephalus. Further evaluation with an MRI is recommended to exclude other possibilities. There is no evidence of residual subdural. Small calcified meningioma along the left petroclinoid ligament is again identified.Images through posterior fossa suggests interval increase in the size of fourth ventricle as well.
1.Increased in size of all ventricular system since prior exam. 2.Increased in periventricular low attenuation is concerning for hydrocephalus and periventricular exudate of CSF.3.correlate with clinical history and if concerned an MRI is recommended.