VP shunt, evaluate ventricles: yearly follow up. Paralytic strabismus, sixth or abducens nerve palsy. There is no appreciable change in the size of mildly dilated supratentorial ventricular system with a right transparietal ventricular catheter in position, which projects into the right anterior corpus callosum. There is partial absence of the septum pellucidum. There is also persistent dilatation of the fourth ventricle with a catheter in position that indents the posterior aspect of the right pons. There is unchanged T2 hyperintensity along the catheter tracts, periventricular white matter, and right cerebellar hemisphere. There is no evidence of intracranial hemorrhage, mass, or acute infarct, although reservoir artifact obscures the right posterior brain. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
1. No appreciable change in the size of mildly dilated supratentorial ventricular system with a right transparietal ventricular catheter in position.2. Persistent dilatation of the fourth ventricle with a catheter in position that indents the posterior aspect of the right pons. 3. Areas of gliosis and/or encephalomalacia along the catheter tracts, periventricular white matter, and right cerebellar hemisphere.4. No evidence of acute intracranial hemorrhage, mass, or acute infarct, although reservoir artifact obscures the right posterior brain.