Clinical question: Evaluate for mass/hydrocephalus/abnormality. Signs and symptoms: Enlarged head. Nonenhanced CT of brain:Significant pan ventriculomegaly with diffuse areas of periventricular low attenuation consistent with transependymal exudate. There is total effacement of cortical sulci and bulge of the brain parenchymal to the patent anterior fontanelle. There is no evidence of intracranial hemorrhage or midline shift. Further evaluation with MRI is recommended. There are no old studies available for comparison.Calvarium is intact however thin secondary to significant hydrocephalus.Visualized mastoid air cells, middle ear cavities, paranasal sinuses and orbits are unremarkable.
Significant pan ventriculomegaly with transependymal exudate of periventricular white matter of bilateral cerebral hemispheres.