Mental portion: Rule out hemorrhage. Signs and symptoms: Altered mental status, gaze deviation. Unenhanced head CT:Since prior CT examination from 9 -- 16 -- 2011 and MRI examination from 9 -- 19 -- 2011 there is interval noticeable increase in the size of the supratentorial ventricular system. There is also resultant partial effacement of cortical sulci throughout bilateral cerebral hemispheres. Finding is consistent with acute hydrocephalus. There is no definitive evidence of periventricular low attenuation to suggest transependymal CSF exudate. There is low attenuation and thickening of the posterior aspect of septum pellucidum when compared with prior two studies. This finding appears to extend posteriorly along the roof of the third ventricle and likely in the velum interpositum. Review post shunted the study demonstrate absence of this finding which is suggestive of exudate of CSF into the septum pellucidum and cisternal velum interpositum. This finding is best appreciated on axial images 13 and 14 and coronal reformatted image 32. Findings were discussed with referring clinical physician Dr Hadipour pager # 3068 at the time of review exam.
1.Interval development of hydrocephalus with resultant partial effacement of bilateral cerebral cortical sulci.2.Low-density soft tissue fullness at the level of septum pellucidum and cisternal velum interpositum likely representing CSF leakage into the cisterns due to patient's hydrocephalus. This finding has resolved on immediate follow-up exam to this study.3.No evidence of periventricular transependymal exudate, hemorrhage or midline shift. 