Female, 53 years old, with history of neurofibromatosis type II, with worsening gait and ataxia. MRI brain and IACs:Findings are redemonstrated compatible with right parietal and bilateral occipital craniotomy. The dura remains diffusely thickened. Superimposed on this are numerous dural based enhancing tumors compatible with meningiomas scattered throughout the intracranial space. These show no significant interval change in size from the prior examination. Some of these lesions are associated with mild parenchymal edema, particularly at the vertex.Enhancing lesions involving both IACs are also redemonstrated compatible with schwannomas. A bulky lesion on the right measures 36 x 26 x 25 mm, previously of similar size when measured in the same manner. This lesion significantly encroaches upon the CP angle cistern and exerts mass effect on the brainstem and pons similar to prior. A much smaller lesion involving the left IAC measures 15 x 6 x 7 mm, unchanged from prior.A small mildly hemosiderin stained surgical cavity or area of encephalomalacia is unchanged along the right middle frontal gyrus. No new intracranial lesions are detected. No new abnormal fluid collections are seen. The ventricles are stable in size and morphology.MRI cervical spine:Numerous small intramedullary enhancing lesions are seen within the cervical spinal cord which appear unchanged in size and number compared to prior exams. A small lesion along the left dorsal surface of the cord at C3 is unchanged as well. A bulky intramedullary tumor at T1 also appears unchanged from the prior exam.At C7-T1, a large extramedullary tumor which may be both intradural and extradural, spanning the right neural foramen, is unchanged in size. This lesion slightly flattens the right ventral spinal cord similar to prior. A bulky left dorsal dural based tumor at T4 is partially visualized.Spinal alignment is anatomic. Vertebral body morphology and signal characteristics are within normal limits. Mild cervical spondylosis is seen with no areas of significant associated spinal canal or foraminal stenosis.A bulky soft tissue mass is partially visualized along the right brachial plexus, as well as another more posteriorly along the right levator scapulae.
1.No significant interval change in the size of multiple intracranial meningiomas, nor of the bilateral IAC schwannomas. No new intracranial masses are identified.2.Numerous intramedullary lesions are redemonstrated in the visualized spinal cord compatible with primary cord tumors, statistically most likely ependymomas. The lesions show no significant interval change in size or number. Multiple extra-medullary tumors representing a combination of schwannomas and meningiomas are also unchanged.