37 years Male (DOB:10/13/1978)Reason: MRI STEALTH - Pre-op, please page neurosurgery resident to place fiducials; CCD History: Cavernoma, OR for resection todayPROVIDER/ATTENDING NAME: ISSAM A. AWAD ISSAM A. AWAD There is an arachnoid cyst within the fourth ventricle measuring 26 x 19 mm in sagittal dimensions which displaces the quadrigeminal plate superiorly. This cyst is stable in size compared to the prior exam.The aqueduct of Sylvius is visualized.There is intraventricular blood layering within the trigones of the lateral ventricles which was also present on the prior exam does not appear to have changed substantially. There is redemonstration of subdural collections. On coronal imaging the right subdural collection measures 5 mm in thickness and previously measured the same. The left subdural collection measures 17 mm in thickness and is unchanged. These collections are septated. The septations do demonstrate some contrast enhancement. There is redemonstration of bilateral frontal porencephaly. There is redemonstration of blood products along one of the components of porencephaly adjacent to the left sylvian fissure.There is redemonstration of ventriculomegaly which appears stable and compared to the prior exam. The third ventricle measures 14 mm in width on the current exam and previously measured the same. Biventricular diameter is approximately 53 mm on the current exam and previously was the same. There is absence of the septum pellucidum. The pituitary gland measures approximately 5 mm in height and 12 mm AP dimension. The sella appears to be distorted. The optic nerves do not appear to be particularly atrophic. The optic nerves are however tortuous and the dural sleeves are relatively dilated. Findings raise the question of papilledema based on its impression on the retina.The right eye is significantly larger than the left eyeThere is redemonstration of siderosis.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 are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.There is a stable ventriculomegaly. The aqueduct of Sylvius is identified and appears to be small..2.There is an arachnoid cyst which occupies and deforms the fourth ventricle. In the face of ventriculomegaly this suggests that this may be a potential cause for the ventriculomegaly.3.There is intraventricular blood present associated with superficial siderosis along the brain surface.4.Bilateral frontal porencephaly.5.Bilateral multiseptated subdural effusions are present which are stable compared to prior exam.6.Buphthalmos is suspected on the right eye. Please correlate with clinical history.7.Findings are suggestive of papilledema. Please correlate with physical findings on clinical exam.