18-year-old male with pineal mass, primarily germinoma of the pineal gland. There has been no significant interval change in the irregular residual pineal gland region enhancement, which again measures up to approximately 9 mm. In maximal dimension (as measured on sagittal T1 postcontrast technique) There are postoperative findings related to endoscopic third ventriculostomy. There is redemonstration of a small stable area of susceptibility along the body of the right lateral ventricle and the adjacent periventricular white matter with a linear tract extending up to the right frontal burr hole with marginal FLAIR hyperintensity, consistent with previous biopsy. Foci of susceptibility are also identified along the right ventricular atrium, unchanged, likely relating to chronic hemosiderin deposition. The ventricles are unchanged in size and configuration. Patchy areas of T2/FLAIR hyperintensity within the periventricular white matter bilaterally are unchanged, which may in part relate to prominent perivascular spaces and associated minimal gliosis. There is no evidence of acute infarction. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are unchanged.
There has been no significant interval change in the irregular residual pineal gland region enhancement.