PMC3205507_01
Coronal T1w image SE 540/14 (a) shows the severe dilatation of right lateral ventricle and consequent compression and loss of brain tissue in the right temporal and occipital region. Axial FLAIR T1 2200/35 (b) presents the enlargement of right atrium and occipital horn with reduced volume of periventricular and subcortical white matter. Parasagittal T1w image SE 550/20 (c) depicts the marked enlargement of the right lateral ventricle with prominent compression and lack of brain parenchyma volume, predominantly in the temporo-occipital region
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F1
The MR investigation showed a severe dilatation of the right ventricle, with the atrial diameter over 34 mm and evident midline shift to the left [Figure 1].
The head circumference evolution: at birth was 36 cm; at 3 months -37 cm; at 6 months -47 cm; 9 months later -47,5 cm;at 21 months -49,5 cm. Now is 50 cm
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F2
The size of the skull corresponded well with the infant age [Figure 2], as well as the cognitive and motor development. The head circumference was corresponding with the child's age [Figure 2].
(a, b) Coronal, axial and sagittal T1w SE 500/14 images show initial/incipient decompression (and decreased size) of the right lateral ventricle after shunting (right transparietal catheter in situ). Rim of brain parenchyma in the right temporo-occipital region is thicker, consequent to the mild increase of brain volume. Also, there is consequent mild atrial diverticulum and displacement of mediosagittal structures. Right frontal horn is slightly rounded, while the left lateral ventricle is completely decompressed
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F3
The atrial diameter was 23 mm [Figure 3].
The second and the third postoperative MRIs present further decompression of lateral ventricle and increase in brain volume
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F4
The right atrial diameter was evidently smaller measuring 17 mm [Figure 4].
The position of catheter seen in axial image (SE 500/7.8) is better visualized on sagittal and coronal planes within different sequences
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F5
After that, the MR was performed three times which presented the evident, dynamic shrinkage of ventricle, and the last one was performed 2 months ago which showed the normal-sized ventricles with the catheter's tip in the same position [Figures 5 and 6].
Sagittal (SE 500/7.8) image shows catheter as a short inferior pericallosal signal void with a tip in the anterior cerebellar lobe and vermis
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F6
After that, the MR was performed three times which presented the evident, dynamic shrinkage of ventricle, and the last one was performed 2 months ago which showed the normal-sized ventricles with the catheter's tip in the same position [Figures 5 and 6].