Presentation
Headaches.
Patient Data
The lateral and third ventricles are again severely enlarged, with enlargement of the supraoptic recess, infundibular recess and pineal recess of the third ventricle. The inferior end of the cerebral aqueduct occluded linear webs or adhesions. There is no CSF flow across the aqueduct. A large defect in the septum pellucidum is present. The A gliotic tract through the right paramedian frontal lobe extending to the right lateral ventricle presumably reflects a prior drainage tube or ventriculostomy pathway.
Conclusion:
Obstructive hydrocephalus due to aqueduct stenosis.
A left parietooccipital ventricular shunt has been introduced, the tip in the left lateral ventricle. The ventricles have not reduced substantially in size. No definite callosal abnormality is seen at this stage.
Ventricular size has reduced and the corpus callosum has descended. The body appears low density. This indicates post-shunting damage.
The corpus callosum is now markedly thinned and irregular.
The thinning and distortion of the corpus callosum are best seen on sagittal images (T2, T1). The third ventricle is small with posterior retraction of the lamina terminalis and anterior commissure.
Case Discussion
Damage of the corpus callosum has been described post shunting for hydrocephalus, thought to be secondary to chronic compression of the corpus callosum against the falx becoming appreciable once the ventricles have been decompressed in the corpus callosum moves inferiorly.
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