 New since the prior MRI of 03/17/16, postop changes are seen related to vascular malformation resection in the area of the left basal ganglia, including restricted diffusion around the resection margin. There are layering blood products in the occipital horn of the right lateral ventricle, also likely postprocedural in etiology.The known cyst within the fourth ventricle is similar in size and appearance to the previous study, displacing the quadrigeminal plate, superiorly. There is questionable increase in the degree of edema in the midbrain adjacent to the cyst. Similarly, there is increased edema adjacent to the occipital horn of the right lateral ventricle. The temporal horns are mildly increased in size when compared to the prior study, by approximately 1 to 2 mm, bilaterally.The CSF is diffusely nonsuppressing on FLAIR, which may relate to debris and/or blood products diluted within the CSF spaces. The septated bilateral subdural fluid collections are similar in size, measuring up to 2 cm adjacent to the left frontal lobe. Stable appearance of bilateral frontal porencephaly. Diffuse superficial siderosis is unchanged.There is new/increased diffuse enhancement of the ventricular walls and ependyma, which may relate to ventriculitis. The dura and subdural septations also diffusely enhance, but this is stable from the previous study. There is expected postoperative enhancement in and around the resection cavity.There is fluid in the left maxillary sinus, similar to previous. The mastoid air cells are clear. Visualized portions of the orbits are intact, although the right globe remains significantly larger than the left.
1.Evidence of resection in the region of the left basal ganglia, with expected local postoperative findings.2.New and/or progressive ependymal enhancement throughout the ventricular system, with slight increase in size of the temporal horns. While this may represent reactive ventriculitis secondary to blood products or debris, the possibility of infection should also be considered.3.Slight increase in the degree of edema in the midbrain adjacent to the known fourth ventricular cyst, as well as around the right occipital horn.4.Stable appearance of other chronic intracranial deformities.