History of NF 1. New right thigh/buttock pain and twitching. Evaluate for hamartomas and neurofibromas. Brain: Examination is slightly motion degraded. No intracranial mass or mass effect is appreciated. No abnormal parenchymal signal abnormality is seen. No restricted diffusion to suggest acute ischemia. No intracranial hemorrhage. The ventricles are within normal limits in size and configuration. No extra-axial collections. Cerebellar tonsils are borderline low-lying measuring up to 3.5 mm below the foramen magnum without clear evidence of Chiari I malformation.Sella and orbits are grossly within normal limits. There is minimal mucosal thickening involving the paranasal sinuses. Bone marrow signal and extracranial soft tissues are within normal limits. There is a small cervical syrinx which is noted at the C5 level and extends inferior, outside the field-of-view, (sagittal STIR series 25 image 16).Lumbar spine:Examination is motion degraded. The lumbar spine is in normal alignment. The vertebral body and disk heights are well-maintained. No worrisome focal marrow signal abnormality is appreciated. The distal spinal cord and conus are within normal limits with the conus terminating at the lower L1level. There is no significant disk bulge, herniation, spinal canal or foraminal stenosis within the lumbar spine. Incidentally seen is a small focus of CSF intensity measuring 9 x 8 mm at the L4-L5 level which may represent a small arachnoid cyst or diverticulum, and of doubtful clinical significance. Specifically no masses within the lumbar spinal canal or neural foramina are appreciated within the limits of noncontrast study. Please refer to separate report for findings in the pelvis. Small subcutaneous nodules are noted in the posterior paraspinous soft tissues compatible with superficial neurofibromas.
1. MRI of the brain without contrast is within normal limits. Cerebellar tonsils are borderline low-lying without clear evidence of Chiari I malformation.2. Incidentally seen on the brain MRI study is a small cervical syrinx at the C5 level which extends inferiorly, outside the field-of-view. Prior cervical spine MRI from 8/24/2012 also demonstrates a small cervical syrinx. Follow-up dedicated cervical and thoracic spine MRI can be considered for further evaluation as clinically indicated.3. No masses within the lumbar spinal canal or neural foramina are appreciated within the limits of noncontrast study. Please refer to separate report for findings in the pelvis.