 Compared to MRI from 7/14/2015 interval decompression of previously seen massively dilated right lateral ventricle is seen. Diffuse thinning of the cortical mantle is again seen. There is development of a large extra-axial collection collection along the right cerebral convexity with mass effect on the right cerebral hemisphere and leftward midline shift which is improved since prior. There is also a small subdural collection along the left cerebral convexity which is new. Small amount of intraventricular blood products are noted layering within the occipital horns. There is also pneumocephalus consistent with recent surgical manipulation. No evidence of acute infarct.Postcontrast images demonstrate abnormal enhancement involving the occipital horns suspicious for ventriculitis. There is also enhancement involving the dura particularly along the left cerebral hemisphere which may be reactive to the adjacent subdural collection or sequela of prior ventricular drainage. No findings to suggest cerebritis or intraparenchymal abscess. Evidence of prior injury with cystic changes involving the left cerebellar hemisphere again noted. The brainstem as well as the cerebellar peduncles are also small.
1. Abnormal enhancement involving the ventricular walls along the occipital horns. Findings are suspicious for ventriculitis. No findings to suggest intraparenchymal abscess or cerebritis.2. Compared to MRI from 7/14/2015 interval decrease in caliber of the previously seen massively dilated right lateral ventricle and development of a large extra-axial collection along the right cerebral convexity with resulting mass effect on the adjacent parenchyma. Leftward midline shift is overall slightly improved in the interval. There is also a small left sided subdural collection which is new since prior.3. Pneumocephalus, thin left-sided subdural collection, and dural enhancement may all represent postprocedural change related to prior ventricular decompression.5. Severe thinning of the cortical mantle and extensive left cerebellar encephalomalacia again seen.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.