10-year-old with worsening seizures. Evaluate for etiology. Redemonstrated findings of severe communicating hydrocephalus with marked dilatation of the supratentorial and infratentorial ventricular system which are not significantly changed from prior. A left parietal ventriculostomy catheter extends to the midline at the level of the third ventricle. There is associated marked thinning of the cortical mantle with areas of confluent increased T2 signal most notably in the left frontoparietal region likely reflecting gliosis.Evaluation the hippocampi and amygdala is limited by distortion from the dilated temporal horns of the lateral ventricles, but the mesial temporal structures are grossly symmetric.Additional postoperative findings from prior right frontoparietal craniotomy. The basal cisterns remain patent. The visualized orbits, paranasal sinuses, and mastoid air cells are clear. The expected intracranial vascular flow-voids are present.
1. Stable findings of severe communicating hydrocephalus with a left parietal ventriculostomy catheter in place.2. Chronic parenchymal abnormalities are noted, but there are no new structural findings to suggest an etiology for the patient's worsening epilepsy.