Diagnosis: Benign neoplasm of brain, unspecifiedClinical question: MRI for pre-op planning for resection of right intraventricular tumorSigns and Symptoms: s/p craniotomy with EVD placement with residual tumor notedComments: There is redemonstration of an intraventricular mass present along the body of the right lateral ventricle. There is associated enlargement of the lateral ventricles which was also present on the prior exam as well as a fluid fluid level in the right lateral ventricle probably representing some blood products. A ventricular catheter courses through the right frontal lobe into the midline and subsequently extends to the third ventricle and has its tip in the third ventricle. The patient is status post removal of ventriculostomy tube previously coursing through the left frontal lobe. There is a tract of T2 high signal present where this catheter previously was present.There is redemonstration of subgaleal fluid present adjacent to bilateral frontal and parietal calvaria which appears to have increased in thickness when compared to the 11/17/2015 exam. It currently measures approximately 12 mm in thickness and previously measured approximately 9 mm in thickness. It is extent also appears to have increased AP dimension was previously around 96 mm and is now approximately 118 mm.The patient is status post right frontal craniotomy. There is a hyperintense T2 signal present within the right frontal lobe extending to the right lateral ventricle.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses demonstrate mild mucosal thickening in the right maxillary sinus. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.A right-sided intraventricular mass is known to represent a central neurocytoma.2.There are postsurgical changes present with subgaleal fluid. The possibility of a CSF leak cannot be excluded on the basis of this exam.3.Abnormal signal in the right frontal lobe most likely represents postoperative change4.Ventriculomegaly.