Pseudotumor cerebri. Recent visual changes. Evaluate for mass or stroke. There is interval removal of the right transfrontal shunt catheter. The left lateral ventricle has slightly re-expanded, while the right lateral, third and fourth ventricles are otherwise unchanged. There is persistent linear T2 hyperintensity along the prior right transfrontal lobe catheter tract and associated focal thinning involving the anterior body of the corpus callosum. A non-enhancing focus of high T2 signal and apparent mild volume loss in the posterior right temporal lobe is unchanged. The pituitary gland appears to be slightly re-expanded. There is no midline shift or herniation. There is no acute intracranial hemorrhage. There is mild unchanged enlargement of the Meckel's caves and the arachnoid granulations in the right transverse/sigmoid sinuses. There is a extra-axial, dural-based, left frontal convexity enhancing lesion that measures 4 mm in width.
1.There is no intracranial mass. In contrast enhancing right frontal signal abnormality related to previous shunt catheter is improved while the nonspecific T2 hyperintensity in the right temporal lobe is unchanged.2.Interval removal of the right transfrontal shunt catheter, such that the left lateral ventricle has slightly re-expanded, while the right lateral, third and fourth ventricles are otherwise unchanged. 3.A subcentimeter extra-axial left frontal convexity mass likely represents a meningioma.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.