Central precocious puberty; child with history of VP shunt. Brain: There is a right transfrontal ventricular shunt catheter that terminates in the right lateral ventricles. The entire ventricular system remains markedly dilated diffusely. There is also diffuse paucity of periventricular white matter, particularly in the frontal lobes. The brainstem is distorted by the enlarged fourth ventricle and may also be atrophic. There is no evidence of intracranial hemorrhage or acute infarct, although assessment is partly limited due to artifact from the shunt reservoir. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable. There are persistently prominent upper cervical and retropharyngeal lymph nodes. There are small nasopharyngeal retention cysts.Pituitary: There is a tiny pars intermedia cyst. The posterior pituitary bright spot is intact. The pituitary infundibulum appears to be relatively thin and anteriorly deviated.
1. Persistent ventriculomegaly with ventricular shunt catheter in position and associated deficiency of periventricular white matter.2. The pituitary infundibulum appears to be relatively thin and anteriorly deviated, perhaps due to pressure from the adjacent dilated third ventricle. 