This composite figure includes radiological imaging of the brain in the axial plane, illustrating the evolution of hydrocephalus associated with ventriculoperitoneal shunt (VPS) malfunction. Panels A and B are T2-weighted MRI scans. Image A shows a significantly dilated, entrapped right lateral ventricle exhibiting a bright, hyperintense signal characteristic of cerebrospinal fluid accumulation due to right-sided shunt failure. Image B shows the same patient shortly after, displaying a reduction in ventricular volume and normalized morphology, indicating a temporary improvement in hydrocephalus. Panel C is a non-contrast axial CT scan showing a recurrence of hydrocephalus. A high-density (bright) linear structure is visible traversing the right cerebral parenchyma and terminating in the enlarged right lateral ventricle, representing the radio-opaque proximal shunt catheter. A separate circular hyperdensity within the calvarium denotes a shunt component or connector. This series highlights the diagnostic utility of MRI and CT in monitoring shunt-dependent hydrocephalus and identifying complications like entrapped ventricles.

A series of five longitudinal neuroimaging studies (axial sections) demonstrating dynamic changes in ventricular size over a two-and-a-half-month period. The series primarily consists of brain MRI (T1-weighted and FLAIR sequences) and one CT scan (April 19). The images illustrate a progression from baseline ventricular morphology on February 15 to progressive ventriculomegaly by March 27, where the lateral ventricles are markedly enlarged and rounded, suggestive of hydrocephalus. Subsequent scans from April 19 and April 30 show a resolution of this enlargement, with the ventricles returning to near-baseline dimensions. This clinical progression demonstrates the fluctuation of ventricular volume, often seen in cases of intermittent hydrocephalus or following neurosurgical intervention such as shunt placement. The images provide high-contrast visualization of the cerebrospinal fluid (CSF) spaces relative to the brain parenchyma, cortical sulci, and periventricular structures, serving as a teaching tool for longitudinal monitoring of intracranial pressure-related changes.

This figure presents two axial cross-sections of the brain highlighting neuroanatomical changes. Image A is a non-contrast Computed Tomography (CT) scan of the head demonstrating significant ventriculomegaly. A red arrow points to the markedly enlarged lateral and third ventricles, which occupy a disproportionate volume relative to the brain parenchyma. Image B is a T2-weighted Magnetic Resonance Image (MRI) with contrast from the same patient. This image clarifies the etiology of the ventricular enlargement, with a red arrow indicating pronounced cerebral atrophy. Key visual findings in image B include the prominent narrowing of cortical gyri and the compensatory widening of the sulci (hydrocephalus ex vacuo). The comparison between these two modalities is used to distinguish between communicating hydrocephalus and secondary ventricular enlargement due to global tissue loss. These diagnostic images are essential for evaluating geriatric patients presenting with the clinical triad of gait instability, urinary incontinence, and cognitive decline, often seen in normal pressure hydrocephalus (NPH) or neurodegenerative processes.

This composite diagnostic image presents a comparative study between Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) of the brain in the context of Idiopathic Normal Pressure Hydrocephalus (iNPH). (a, b) Axial CT and T1-weighted MRI at the vertex level demonstrate 'disproportionately enlarged subarachnoid space hydrocephalus' (DESH), characterized by narrow sulci at the high convexity and midline, contrasting with focally enlarged sulci elsewhere. (c, d) Coronal CT and T1-weighted MRI sections highlight significant ventriculomegaly and prominently dilated Sylvian fissures, a classic diagnostic feature of iNPH. (e, f) Axial CT and T2-FLAIR MRI sequences at the level of the lateral ventricles illustrate extensive periventricular white matter changes. These appear as hypodense regions on CT and hyperintense signals on T2-FLAIR, surrounding the dilated lateral ventricles. The images serve to illustrate how both CT and MRI can identify key morphological markers of hydrocephalus, including sulcal effacement, sylvian fissural widening, and white matter signal alterations for clinical evaluation.