Female, 32 years old, with headache and shunt tract tenderness. Assess for abnormalities along the VP shunt. Brain:Please note that artifact from the patient's shunt apparatus does obscure visualization of some right-sided structures, particularly on the diffusion and susceptibility sequences.A right frontal approach ventricular shunt catheter is evident, tip situated at the level of the foramina of Monro. This portion of the catheter system is in stable position. The caliber of the ventricular system is unchanged relative to recent prior CTs, and slightly smaller compared to an older MRI from 2013. Mild gliosis and encephalomalacia are demonstrated along the catheter tract as it traverses the frontal lobe.The remaining parenchyma demonstrates normal signal intensity and morphology. No restricted diffusion or other significant signal abnormality is seen. No evidence of intracranial hemorrhage or any abnormal fluid collection is seen. Where images are not degraded by artifact, no definite pathologic enhancement is detected. Neck:The right-sided shunt system is visualized as it courses down though the posterior neck soft tissues, into the supraclavicular region, over the clavicle and down the anterior subcutaneous tissues of the right chest. At no point along this pathway is any fluid collection, mass, pathologic enhancement or evidence of inflammation detected.Small benign-appearing lymph nodes are evident on both sides of the neck. The mucosal tissues of the pharynx, larynx and trachea appear unremarkable. Salivary glands and the thyroid seem to be free of focal lesions. The marrow signal characteristics are unremarkable. Spinal alignment is anatomic and the spinal cord as visualized is unremarkable.
1.Limited examination of the brain due to artifact from the patient's shunt apparatus. Within this limitation, no acute abnormalities are suspected, and no shunt complications are seen.2.No specific abnormality is detected along the pathway of the right-sided shunt catheter as it traverses the soft tissues of the neck.