Pineal parenchymal tumor of intermediate grade. There are post-treatment findings related to right parieto-occipital craniotomy. There is interval decrease in size of the heterogeneously enhancing pineal mass which measures up to 24 mm, previously 31 mm. Furthermore, the predominantly T1 hyperintense hemorrhage within the tumor has dissipated or evolved, with a few punctate areas of residual susceptibility within the tumor. There has been interval decrease in size of the third and lateral ventricles. There is a right transfrontal ventricular catheter that terminates in the right lateral ventricle. There are scattered foci of susceptibility effect within the ventricular system likely represent hemosiderin deposit from the prior intraventricular hemorrhage. There is unchanged encephalomalacia in the right occipital lobe. There are unchanged scattered nonspecific foci of T2 hyperintensity in the cerebral white matter. There is no evidence of acute infarct. There is no midline shift or herniation. There is persistent mild fluid signal in the left mastoid air cells. The left occipital subcutaneous nodule is not significantly changed.
1. Interval decrease in size of the pineal mass associated with interval subsidence of the intratumoral hemorrhage. 2. Interval decrease in size of the third and lateral ventricles due to decreased obstructive effects from the pineal tumor, but residual areas of chronic intraventricular hemorrahge.3. The nonspecific left occipital subcutaneous nodule is not significantly changed.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.