A 1-year-old boy with suspected post-infectious hydrocephalus presents with an enlarging head, decreasing developmental milestones and a history of high fevers several months prior. Axial CT scan through frontal horns (a) shows dilated lateral, third and fourth ventricles. The third ventricle (*) is displaced to the right by a fluid collection with rim enhancement in the left temporal lobe, likely due to focal cerebritis with abscess (arrows). Coronal scan through the vertex (b) shows hypodensity in the periventricular white matter, consistent with transependymal migration of cerebrospinal fluid (arrowheads) and sulcal effacement concerning for cerebral edema and elevated intracranial pressure