19-year-old male with newly diagnosed germinoma presenting with headaches, nausea, and vomiting. Evaluate for hydrocephalus. Postoperative changes status post right frontal craniotomy are again evident, with interval decrease in pneumocephalus and extra-axial fluid. No acute intracranial hemorrhage is evident. Again seen is diffuse decreased attenuation in the subcortical and periventricular white matter in the frontal lobes bilaterally which appear grossly unchanged. Hyperdense masses are again seen in the suprasellar and pineal regions, correlating with lesions seen on recent MRI. The suprasellar mass appears more prominent compared to the prior exam, which may be in part due to slice thickness and partial volume averaging. Hypodensity in the right periependymal region adjacent to the frontal horn of the right lateral ventricle is again seen, causing mass effect upon the ventricle at this level. The ventricles remain midline, with interval increase in volume of the lateral ventricles. The third and fourth ventricles demonstrate normal morphology and volume.Postoperative changes status post right frontal craniotomy, with the remaining calvaria stable in appearance. The visualized paranasal sinuses and mastoid air cells are normally pneumatized.
1. Interval increased volume of the lateral ventricles.2. Increased prominence of suprasellar mass, which may in part be due to slice thickness and partial volume averaging. Stable appearance of pineal mass. 3. Postoperative changes status post right frontal craniotomy, with no acute intracranial hemorrhage.