 There is persistent marked dilatation of the lateral ventricles with absence of septum pellucidum. There is a VP shunt tube with right parietal approach and positioning of the distal tip to the right of the midline at the level of the lateral ventricles. There is a subdural catheter with the right hemispheric subdural space. Both above catheters are unchanged. The ventricular size has decreased from 12 cm transfrontal diameter on the previous study to 9.1 cm ion the current study with interval expansion of the brain parenchyma. As before, the cerebral aqueduct is not well visualized. There is a low lying leftward cerebellar tonsil extending 1.4 cm below the foramen magnum. The cerebellum is dysmorphic with partial rhombencephalosynapsis. The superior cerebellum herniates through the cerebellar incisura, which is more prominent than on the previous study, likely indicating interval growth of parenchyma. There is minimal detectable CSF flow around the cerebellum and across the foramen magnum on cine flow imaging.
1. Interval improvement in the degree of ventriculomegaly with concomitant expansion or growth of the brain parenchyma. Stable positioning of the ventricular and subdural catheters.2. Low lying cerebellar tonsil with partial rhombencephalosynapsis. The superior cerebellum herniates through the cerebellar incisura, which is more prominent than on the previous study, likely indicating parenchymal growth.