Pre-operative planning for choroid plexus papilloma. There are postoperative findings related to suboccipital craniotomy. There is a lobulated enhancing mass within the inferior portion of the fourth ventricle that measures up to 27 mm. There is persistent dilatation of the superior portions of the fourth ventricle, as well as the third and lateral ventricles, with associated diffuse periventricular T2 hyperintensity. There is a right transfrontal ventricular catheter that terminates in the left lateral ventricle. There is mild high T2 signal in the parenchyma surrounding the catheter. There is no evidence of acute cerebral infarction or intracranial hemorrhage. There is a 6 mm wide arachnoid cyst anterior to the anterior temporal pole. There is a retention cyst in the left maxillary sinus. Scalp fiducial markers are present.
Preoperative planning MRI demonstrates a fourth ventricular choroid plexus tumor associated with persistent obstructive hydrocephalus and transependymal edema, with a right transfrontal ventricular shunt catheter in position.