Female, 31 years old, with headaches, history of hydrocephalus and VP shunt in place. A right frontal approach ventricular catheter is redemonstrated, terminating at the level of the right lateral ventricle. T2 hyperintensity has progressed within the parenchyma surrounding the catheter as it traverses the right frontal lobe. In association with this progressive signal abnormality, there appears to be a new subcentimeter pocket of fluid surrounding a small portion of the catheter (see image 20 of series 401).The ventricles are uniformly small and, since the prior examination, the caliber of the ventricular system has further decreased. The basal cisterns remain patent.T2 hyperintensity and swelling within the body of the corpus callosum has progressed since the prior examination. Scattered additional nonspecific foci of T2 hyperintensity within the cerebral hemispheres are unchanged. No evidence of restricted diffusion is seen, though the diffusion sequences are significantly degraded by susceptibility artifact. A few scattered punctate foci of susceptibility are evident through the cerebral hemispheres compatible with microhemorrhage, but again, a large portion of the susceptibility sequence is degraded by artifact from the shunt system.
1.An area of progressive T2 hyperintensity is seen along a portion of the right frontal ventricular catheter. This is associated with a subcentimeter pocket of fluid which surrounds the catheter. Findings could represent either a reactive or an infectious process.2.Progressive signal abnormality and swelling of the body of the corpus callosum is seen. This is an occasional reported complication of shunting, though the exact etiology for it has not been established.3.The ventricular system is small in caliber and has further decreased in size and the prior MRI.