NF-2, bilateral vestibular schwannomas who presents with acute on chronic gait worsening with extramedullary lesions observed on MRI causing thoracic spinal cord compression, status post thoracic spinal cord lesion removal. There are interval postoperative findings related to resection of an intradural extramedullary meningioma at the T4 level via bilateral T3, T4, and T5 laminectomy. There is fluid within the paraspinal space and epidural space along the surgical approach with associated narrowing of the thecal sac, such that there is minimal cerebrospinal fluid surrounding the spinal cord at the T3 though T5 levels. However, there is no measurable residual meningioma at this level. There are otherwise unchanged multiple enhancing tumors within the spinal canal, including an intradural extramedullary tumor that measures 5 mm in thickness within the left anterolateral aspect of the spinal canal at C4 and numerous subcentimeter nodules along the conus and nerve roots of the cauda equina. There are also multiple unchanged enhancing lesions within the cervical and upper thoracic spinal cord. The previously demonstrated bilateral internal auditory canal lesions are only partially-imaged. The vertebral column alignment is within normal limits. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is unremarkable.
1. Interval postoperative findings related to resection of an intradural extramedullary meningioma at the T4 level via bilateral T3, T4, and T5 laminectomy. There is fluid within the paraspinal space and epidural space along the surgical approach with associated narrowing of the thecal sac, such that there is minimal cerebrospinal fluid surrounding the spinal cord at the T3 though T5 levels. However, there is no measurable residual meningioma at this level. 2. An intradural extramedullary tumor that measures 5 mm in thickness within the left anterolateral aspect of the spinal canal at C4 likely represents a meningioma.3. Numerous subcentimeter nodules along the conus and nerve roots of the cauda equina likely represent peripheral nerve sheath tumors. 4. Multiple lesions within the cervical and upper thoracic spinal cord likely represent ependymomas.5. The previously demonstrated bilateral internal auditory canal lesions are only partially-imaged. 