Usually the most frequent sign of ventriculitis is
intraventricular debris and pus. Abnormal periventricular intensities or
enhancements are also seen. Both FLAIR and DWI sequences contribute to the
diagnosis of ventriculitis.
Periventricular hyperintensities are generally present
around the anterior and posterior horns of lateral ventricle in
ventriculitis. If patient has
hydrocephalus it can due to CSF ooze. In old patients this finding could be
confused with chronic ischemic changes. DWI generally is helpful in
differentiating these conditions from ventriculitis. Post gadolinium
administration also shows enhancement along the ventricular walls.
In this case there was subtle enhancement along the
ventricular walls. However, there was significant restriction on DWi and high
signal intensity on FLAIR sequences. The T2W image also shows periventricular
hyperintensity, but it is difficult to differentiate from adjacent CSF in the
This patient had positive CMV IgG and IgM.