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What do my lab test reports indicate?

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Posted on Mon, 23 May 2016
Question: I have a family member with congenital hydrocephalus. He is 54 years old. He had a shunt inserted when he was 8 months old. In the past 12 months he has developed a very bad gait. I have uploaded the MRI that was recently done. Your opinion on the results would be appreciated greatly.

The MRI is on this google drive link with CT scans as well. For the MRI I have uploaded the DICOM file. If you can not view it please advise and I will fix.

https://drive.google.com/folderview?id=00000000=sharing CT
https://drive.google.com/folderview?id=00000000=sharing MRI
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Answered by Dr. Vivek Chail (2 hours later)
Brief Answer:
Please discuss given points with the doctor

Detailed Answer:
Hi,
Thanks for writing in to us.

I have read through your query in detail.
Please find my observations below.

1. I have seen the MRI scan dated december in detail. The is difficulty in seeing the old CT scan pictures but I have read through the reports.

2. The previous findings in CT dated 2015 are seen in the MRI scan. In addition I would like to discuss some points.

(i) There is what appears to be cystic dilatation of the third ventricle. There is a thin septa which can be seen separating the third from right lateral ventricle. This is probably there in earlier scans and I wish to know if the MRI report contains any mention of it.

(ii) The medulla is slightly deformed on the right side. This again can be pr existing from childhood. I am not sure if your doctor meant to do any hind brain surgery keeping in mind this region.

(iii) The corpus callosum agenesis, prominent transverse sinus on right side and left parasagittal CSF collection is seen on earlier scans.

(iv) The skull is thickened due to dilantin treatment. The VP shunt is in situ.

(v) The cervical spine shows mild degenerative changes.

3. I recommend that you discuss these points (i) through (v) with the doctor and if clinically indicated then a contrast brain MRI scan can be done in view of the abnormality in gait which has developed recently.

Please do let me know about the previous telephone conversation regarding the hind brain surgery which was initially communicated to you and if it was discussed in detail with the doctor and any treatment offered.

Hope your query is answered.
Please do write back if you have any doubts.

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Vivek Chail

Radiologist

Practicing since :2002

Answered : 6786 Questions

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What do my lab test reports indicate?

Brief Answer: Please discuss given points with the doctor Detailed Answer: Hi, Thanks for writing in to us. I have read through your query in detail. Please find my observations below. 1. I have seen the MRI scan dated december in detail. The is difficulty in seeing the old CT scan pictures but I have read through the reports. 2. The previous findings in CT dated 2015 are seen in the MRI scan. In addition I would like to discuss some points. (i) There is what appears to be cystic dilatation of the third ventricle. There is a thin septa which can be seen separating the third from right lateral ventricle. This is probably there in earlier scans and I wish to know if the MRI report contains any mention of it. (ii) The medulla is slightly deformed on the right side. This again can be pr existing from childhood. I am not sure if your doctor meant to do any hind brain surgery keeping in mind this region. (iii) The corpus callosum agenesis, prominent transverse sinus on right side and left parasagittal CSF collection is seen on earlier scans. (iv) The skull is thickened due to dilantin treatment. The VP shunt is in situ. (v) The cervical spine shows mild degenerative changes. 3. I recommend that you discuss these points (i) through (v) with the doctor and if clinically indicated then a contrast brain MRI scan can be done in view of the abnormality in gait which has developed recently. Please do let me know about the previous telephone conversation regarding the hind brain surgery which was initially communicated to you and if it was discussed in detail with the doctor and any treatment offered. Hope your query is answered. Please do write back if you have any doubts. Regards,