30 years Male (DOB:5/23/1986)Reason: epilepsy History: surveillancePROVIDER/ATTENDING NAME: PETER C. WARNKE PETER C. WARNKE There is a cystic mural nodule mass present centered in the upper fourth ventricle and aqueduct which currently measures 46 x 41 mm sagittal dimensions and previously measured 41 x 37 mm sagittal dimensions. On axial imaging the mass measures 40 x 38 mm and previously measured 38 x 34. There are some punctate foci of susceptibility effect within the lesion as well as scattered within the lateral ventricles. These were also present on the prior exam. This enhancing component of the lesion measures approximately 22 x 22 mm axial dimensions and previously measured 22 x 22 mm axial dimensions. There is a catheter which courses through the right frontal bone into the right frontal lobe, into the right lateral ventricle and from there into the cystic portion of the lesion with its tip abutting the solid component. Another catheter courses to the right frontal lobe into the right lateral ventricle with tip in the body of the right lateral ventricle. Biventricular diameter on coronal imaging measures 61 mm on the current exam and previously measured 61 mm. A small focus of encephalomalacia is present in the right occipital lobe probably representing a ventriculostomy tube tract.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses demonstrate minor opacities. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.There is a fourth ventricular and the aqueductal mass present associated with ventriculomegaly. The mass is a cyst and mural nodule appearing mass which is mildly enlarged compared to the previous exam. The enhancing component of the mass is stable. This is known to represent a pleomorphic xanthoastrocytoma2.There is redemonstration of catheters within the right lateral ventricle and another one within the cystic component of the mass. Since the prior exam the lateral ventricles are stable.3.