 There is metallic artifact in the right frontal lobe due to craniotomy / drainage device. Since the previous study the ventricles were decompressed and currently appears within normal size. Again there are a multiloculated CSF signal intensity cystic lesions in the right thalamus and midbrain and its associated mass effect/effacement of the posterior third ventricle that remains identical to prior exam. The pontine high signal intensity on FLAIR and T2 images is unchanged. A drainage tube is seen coming entering the brain from the right frontal lobe and the distal tip is seen in the third ventricle. High T2 and FLAIR signal is seen around the tube, due to gliosis.There is no restricted diffusion. Susceptibility low signal is seen dispersed in the right frontal lobe and midbrain, most likely due to petechial hemorrhage versus calcification.There is no midline shift. Contrast images demonstrates no significant abnormal enhancement.There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. The paranasal sinuses and mastoid air cells are clear.
1. Status post craniotomy with drainage system that that demonstrates significant decompression of the ventricular system.2. Again seen are multiple loculated CSF signal cysts in the right thalamus, posterior third ventricle, and the pons, unchanged from the previous study.