Left optic disc swelling and vision loss. History of venous tributary occlusion of retina on the right and breast cancer. Brain: There is a homogeneously enhancing extra-axial mass overlying the left lateral temporal convexity that measures up to 15 mm in width with associated hyperostosis. There is no evidence of intracranial hemorrhage or acute infarct. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.Orbits: There is diffuse enhancement and prominent high T2 signal along the left optic nerve sheath and protrusion of the left optic nerve disc. The left optic nerve itself displays high signal on diffusion-weighted imaging, perhaps due to pressure effects, but displays normal T2 signal and no associated enhancement. There is no discrete mass lesion in the right orbit. The left extraocular muscles and lacrimal gland are unremarkable. The right optic nerve appears to be relatively atrophic. The right orbit is otherwise unremarkable.
1. Findings suggestive of left optic perineuritis versus perhaps an infiltrative neoplastic process.2. Unchanged left lateral temporal convexity probable meningioma.