persistent symptom of dizziness, history of seizure and VP shunt. No evidence of acute ischemic or hemorrhagic lesion on this scan.VP shunt inserted via right posterior temporal lobe and the tip is located right lateral ventricle frontal horn area. Especially on the right temporal approached through the right parietal white matter, VP shunt track shows high signal intensity on FLAIR indicating localized encephalomalcia through the VP shunt track.The ventricles, sulci and cisterns are symmetric and unremarkable. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate normal distal ICAs, MCAs, and ACAs.Acom artery is patent but bilateral Pcom arteries are not seen. Vertebrobasilar system appears to be normal.There is no evidence of intracranial arterial aneurysm or arterial luminal stenosis.3D MRA neck post-gadolinium images with maximum intensity projections of the cervical vasculature demonstrate normal flow enhancement in a normal aortic arch origin of the right brachiocephalic, left common carotid, and left subclavian arteries. The vertebral artery origins are normal. There is normal flow enhancement through the bilateral common carotid, carotid bifurcations, internal/external carotid, and vertebral arteries.
1. No evidence of acute ischemic or hemorrhagic lesion on this scan.2. Ventriculostomy tube through the right posterior temporal lobe via parietal white matter and located in the right lateral ventricle. No significant interval change since prior exam.3. Normal brain MRA and neck MRA. 