New brain mass and hydrocephalus. Brain MRI:Redemonstrated is an heterogeneous complex cystic multiseptated appearing mass in the right lateral ventricle that measures 17 x 30 mm on axial view and 22 mm CC, unchanged. It abuts and possibly arises from the septum pellucidum. Tumor extends into and occupies the right half of the third ventricle. There appears to be minimal enhancement of the mass which is complicated by the small amount of adjacent hemorrhage. The right greater than left lateral ventricle and third ventricle enlargement is stable and there is subependymal T2 hyperintensity which suggest chronic CSF migration. The fourth ventricle and cerebral aqueduct are normal. Again seen is a left frontal approach EVD with distal tip adjacent to the wall of the body of the right lateral ventricle. Susceptibility abnormality is seen in the right lateral ventricle anteriorly and along the EVD tract, and near the right foramen of Monro along the inferior margin of the mass, which may be post-procedural blood product. There is some enhancement of the anterior horn of the right lateral ventricle which may be related to reaction to the blood products. The gray-white matter differentiation is preserved. There is no midline shift. There is mild scattered mucosal thickening in the paranasal sinuses.Spine MRI:CERVICAL SPINE
1.Redemonstration of a complex cystic enhancing mass involving the anterior horn and body of the right lateral ventricle with extension into the right foramen of Monroe and third ventricle. It is suspected that it may even extend towards the aqueduct of Sylvius. The differential includes choroid plexus tumor, astrocytoma, central neurocytoma or ependymoma/subependymoma.2.Stable ventriculomegaly involving the lateral ventricles and third ventricle.3.Unchanged EVD tip appearing along the wall of the body of the right lateral ventricle. Blood products are again along the EVD and near the tip which are likely post-procedural.4.No findings in the spine to indicate malignancy or metastasis.5.Mild disc bulge involving the L4-5 level and right greater than left L5-S1 disc bulge with a lateral disc protrusion which causes impression on the exiting right lateral S1 nerve root. No central canal stenosis.