PMC5618997_01
[A] Noncontrast brain CT-scan after first shunt derivation shows catheter
tip of ventricular peritoneal shunt into right lateral ventricle,
absence of ventricular dilatation and slight increase in right Sylvian
fissure. [B] Follow-up noncontrast Brain CT-scan four years later after
shunt replacement shows moderate dilatation of lateral ventricles and
multiple cystic lesions in right Sylvian fissure.
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Also, a CT scan performed after the derivation showed resolution in hydrocephalus, and a slight increase in the right Sylvian fissure was depicted (Figure 1 A).
[A] Axial FLAIR, [B] Axial T2WI, [C] Axial T1W1 with gadolinium. [A, B]
shows multiple cystic lesions without scolex in right Sylvian fissure.
[C] gadolinium-enhanced MR image shows diffuse arachnoid enhancement
surrounding the cysts. [D] Axial FLAIR, [E] Axial T2WI, [F] Axial T1W1
with gadolinium. [D, E and F] follow-up Brain MRI after second shunt
replacement shows absence of hydrocephalus and slight enlargement of
right Sylvian fissure. [F] slight enhancement in right Sylvian fissure,
previously containing multiple cysts.
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There were multiple cysts in the right Sylvian fissure, without scolex, and peripheral enhancement, whose appearance resembled a "bunch of grapes" (Figure 2, A, B and C). Follow-up brain MRI was performed and showed resolution of hydrocephalus, remarkable reduction in the number of cysts in the Sylvian fissure, with persistent slight peripheral enhancement after gadolinium and high signal intensity on T2 / Flair (Figure 2, D, E and F).