Neurofibromatosis, type 2 [Q85.02] / Dysphagia, unspecified [R13.10], Reason for Study: ^Reason: eval for midbrain disease/infarct History: acute dysphagia, Brain MRIThere is dumbbell shaped extra axial mass appears to be attached to the inferior aspect of the right acoustic schwannoma extends toward right jugular foramen in particular pars nervosa indicating extension of the tumor. Thought it has not been separately reported, there is no interval change since prior scan.There are multiple extra axial enhancing masses involving bilateral acoustic schwannomas, left sylvian fissure enhancing lesion, and multiple dural based enhancing lesions indicating meningiomas, unchanged since prior scan.Multifocal FLAIR high signal intensity lesions of bilateral white matter are again seen, unchanged since prior scan. There is no evidence of acute ischemic or hemorrhagic lesion on this scan.The ventricles, sulci and cisterns are symmetric and unremarkable. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses are clear. Bilateral mastoid air cells show opacifications, unchanged since prior scan.Cervical Spine MRIMore prominent spinal cord T2 high signal intensities are seen at the level of C45 to C56 level especially on the right side. This is likely representing mixed partial volume effects of extradural intraspinal component of residual mass as well as increased extent of spinal cord edema.In addition, at the level of C67, there is T2 high signal intensity lesion on the left side of the spinal cord which is more likely representing spinal cord edema. Again this lesion was seen previously but appears to be more prominent than before. Other findings including prior C3 to C6 laminectomies, scattered intra axial enhancing lesions at medullar and upper cervical spinal cord, right C2 root mass, C45 right neural foraminal and intraspinal mass which still shows some mass effects against spinal cord, right C56 extraforaminal mass, C67 bilateral extraforaminal masses, C7T1 bilateral extraforaminal masses likely representing schwannomas are unchanged since prior scan.Kyphotic deformity of the C spine at the level of C56 with fluid collections on the laminectomy sites are again unchanged since prior scan.
1. No evidence of acute ischemic or hemorrhagic lesion on this scan.2. Multiple schwannomas on bilateral IACs and right jugular foramen as well as dural based enhancing lesions likely representing meningiomas are again seen, unchanged since prior scan.3. C45 to C67 spinal cord T2 high signal intensity lesions on the right side and left side spinal cord at the level of C67 lesion are more prominent on today's scan since prior scan which implies increased extent of spinal cord edema. 4. Multifocal various sized extraforaminal and intraspinal masses on cervical spine as well as intramedullar lesions do not show any significant interval change since prior scan as described above. 