AQUEDUCTAL STENOSIS WITH HYDROCEPHALUS AND VP SHUNT MALFUNCTION скачать в хорошем качестве

AQUEDUCTAL STENOSIS WITH HYDROCEPHALUS AND VP SHUNT MALFUNCTION

18 YRS MALE PRESENTED WITH HEADACHE SINCE 3 DAYS,2 EPISODE OF VOMITING AND GIDDINESS AND IMBALANCE OF GAIT H/O 1ST VP SHUNT DONE ON WHEN PATIENT IS 7 MONTHS OLD CHILD H/O 2ND VP SHUNT REVISION ON 30/12/2014 AT ANOTHER HOSPITAL O/E:CONSCIOUS AND ORIENTED ,PUPILS B/L ERTL ,GCS-E4M6V5,SUNSET SIGN PRESENT,UPWARD GAZE NYSTAGMUS PRESENT, BILATERAL PAPILLEDEMA PRESENT. HEMATOLOGICAL WORK UP SHOWED NORMAL FINDINGS HE HAD BEEN INVESTIGATED WITH MRI BRAIN- POST VP SHUNT IN SITU,THERE IS MODERATE DILATATION OF LATERAL /3RD VENTRICLE WITH NARROWING AT THE LEVEL OF AQUEDUCT,THE VENTRICLE CALIBER ARE AS FOLLOWS,TEMPORAL HORN OF LATERAL VENTRICLE 1.8CMS,FRONTAL HORN LATERAL VENTRICLE 2.6CMS,3RD VENTRICLE 2.2CMS,CORTICAL MANTLE AT THE LEVEL OF FRONTAL HORN -1.5CMS,THE 4TH VENTRICLE IS NORMAL IN CALIBER,DIFFUSE CEREBRAL EDEMA NOTED WITH MINIMAL PERIVENTRICULAR INTERSTITIAL EDEMA PATIENT UNDERWENT ENDOSCOPIC THIRD VENTRICULOSTOMY POST-OP PATIENT WAS BETTER WITH RESOLVING SUNSET SIGN AND NYSTAGMUS DISAPPEARED GRADUALLY POST-OP 26/2/2019- COMPARED TO PREVIOUS MRI STUDY DATED 23/2/2019.POST VP SHUNT /OPERATIVE CHANGES NOTED IN RIGHT FRONTAL /PRIETAL LOBE WITH MINIMAL PNEUMO/HEMOVENTRICLE,IN-HOMOGENEOUS CSF FLOW SIGNALS NOTED IN BASILLAR CISTERN AND 3RD VENTRICLE,THERE IS MILD DECREASE IN MODERATE DILATATION OF LATERAL /3RD VENTRICLE ,,THERE IS MILD DECREASE IN MODERATE DILATATION OF LATERAL /3RD VENTRICLE WITH NARROWING AT THE OF AQUEDUCT,HE 4TH VENTRICLE IS NORMAL IN CALIBER,THERE IS DECREASE IN DIFFUSE CEREBRAL EDEMA NOTED WITH MINIMAL PERIVENTRICULAR INTERSTITIAL EDEMA