15 years Male (DOB:8/3/2000)Reason: Recurrent JPA History: post opPROVIDER/ATTENDING NAME: ELIZABETH M DRUMM ELIZABETH M DRUMM Since the prior exam and heterogeneously enhancing mass located at the right pontomedullary junction associated with a septated multicystic component has remained in general stable. The enhancing component currently measures 46 x 26 mm axial dimensions and on 12/22/2015 measured the same. Please note that the postcontrast study from 12/23/2015 had minimal contrast enhancement likely due to injection. The appearance of the mass is similar to the 12/17/2015 exam where it is multiseptated and heterogeneous on T2 and FLAIR pulse sequences and enhances heterogeneously. The overall dimensions of the lesion also appear stable compared to that exam. There is associated distortion of the adjacent brainstem. The mass effects the right internal auditory canal and hypoglossal canal structures and abuts the right trigeminal nerve. The mass displaces the right trigeminal nerve.There is redemonstration of ventriculomegaly with enlargement of the temporal horns of the lateral ventricles. Biventricular diameter on coronal imaging at the level of foramen of Monro is currently approximately 66 mm and previously was approximately 67 mm. Third ventricular diameter remains at 17 mm.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.Since prior exam of 12/17/2015, a posterior fossa neoplasm which is consistent with the patient's diagnosis of pilocytic astrocytoma and is centered at the right half of the pontomedullary junction has not changed substantially in size.2.Since the prior exam ventriculomegaly has remained stable.