Chronic shunting and calvarium thickening

Case contributed by Dr Mersad Mehrnahad

Presentation

Chief complaint of headache, nausea and vomiting.

Patient Data

Age: 16 years
Gender: Male

Irregularity, septation and dilation of left lateral ventricle secondary to previous ventriculitis is depicted. Calvarium thickening secondary to chronic shunting is noted.

Cerebellar tonsil herniation and syringomyelia of upper cervical cord associated with an indistinct corpus callosum. Only the genu of the of corpus callosum is depicted (which is the first part of corpus callosum that is formed). Irregularity, septation, entrapment and dilation  of left lateral ventricle possibly secondary to previous ventriculitis and malfunction of VP shunt is seen. A large interhenispheric cyst is also seen also. Calvarium thickening because of chronic shunting is seen.

Case Discussion

It is unclear whether tonsillar descent is congenital (Chiari I malformation) or secondary to downward compression by the cyst. On these selected images it is also difficult to assess whether there is true dysgenesis of the corpus callosum or if it has been thinned by severe prior hydrocephalus. 

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Case information

rID: 52685
Case created: 17th Apr 2017
Last edited: 22nd Apr 2017
Inclusion in quiz mode: Excluded

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