21 years, Female, with cystic lesion in the left frontal brain on CT. A left frontal approach ventriculostomy shunt catheter is redemonstrated with the tip terminating in the anterior horn of the left lateral ventricle near the midline. A focal area of susceptibility artifact at the level of the catheter tip may relate to calcification or tiny metallic component. The ventricles are again diffusely dilated since 9/25/2003, but unchanged since 8/24/2016. The 4 cm cystic fluid collection in the white matter of the left frontal lobe, which surrounds the ventriculostomy catheter is again noted. This lesion demonstrates signal characteristics identical to CSF on all sequences. No enhancing component is identified. There is associated mild mass effect on the frontal horn of the left lateral ventricle with downward displacement and minimal, 6 mm, rightward midline shift at the level of the cyst. There also appears to be septation/loculation of fluid involving the frontal horn and body of the left lateral ventricle. Surrounding T2 hyperintense signal may reflect edema and/or gliosis. There is also linear area of gliosis demonstrated in the right frontal lobe, presumably related to old right frontal approach ventriculostomy catheter. Fourth ventricle also noted to be dilated as seen on recent CT. No restricted diffusion to suggest acute ischemia. No intracranial hemorrhage is noted. There is no solid or suspicious enhancing intracranial mass identified. No abnormal parenchymal or meningeal enhancement. Major flow-voids are preserved.Sella and orbits are grossly within normal limits. Paranasal sinuses and mastoid cells are clear. Bone marrow signal and extracranial soft tissues are within normal limits.
1. CSF fluid collection surrounding the left transfrontal approach ventriculostomy catheter in the left frontal lobe as seen on prior CT of the head. Mild associated mass effect and surrounding edema and/or gliosis. No evidence of superimposed infection.2. Mildly dilated ventricular system as seen on recent CT including the fourth ventricle. There is also suggestion of septation within the left lateral ventricle.