Neurofibromatosis type II. Bilateral tinnitus. Headache. BRAIN:The nodular thickening of the supratentorial dura over the cerebral convexities is very minimally increased since the previous examination from October 2014. For example, the largest component overlying the right parietal lobe has a maximum thickness of 9 mm on coronal imaging, compared to 7 mm previously. While multiple meningiomas also abut the superior sagittal sinus, its T2 flow-void is largely preserved.The more focal dural-based, contrast-enhancing mass arising from the undersurface of the left tentorium cerebelli posteriorly has slightly increased in size. In the axial plane, it now measures 18 mm x 15 mm compared to 13 mm x 12 mm in October 2014 and 12 mm x 12 mm in May 2013. It causes mass-effect on the adjacent cerebellum but no intrinsic signal abnormality with preserved intervening CSF cleft. The adjacent left transverse sinus is preserved as well.Right frontal ventriculostomy catheter is unchanged, with its tip lying in the body of the right lateral ventricle. The lateral and third ventricles remain small in size. There is unchanged severe thinning of the anterior corpus callosum body and the posterior part of the genu. Focal T2-hyperintensity in the subcortical white-matter of the in the medial posterior left frontal lobe remain unchanged. There is no midline shift or brain herniation. There is no intra-axial mass. The frontal and parietal sulci remain slightly larger on the left.Susceptibility effect along the tract of the right ventriculostomy catheter and in ventricular lining in the region of the ventriculostomy catheter is unchanged. There is no acute intracranial hemorrhage. There is trace ethmoid and maxillary sinus mucosal thickening. The orbits are grossly unremarkable.INTERNAL AUDITORY CANALS:Similar to the meningiomas, the contrast-enhancing masses within the internal auditory canals, compatible with bilateral schwannomas, are very minimally increased compared to the previous examinations. The largest, which is on the left, measures 7 mm x 5 mm now, compared to 6 mm x 4 mm in October 2014 and 5 mm x 5 mm in May 2013.
1.Compared to October 2014 examination, the right frontal ventriculostomy is unchanged nor the slipped line lateral and third ventricles. Also, severe corpus callosal thinning and the focal abnormal left frontal lobe signal remain unchanged and probably reflect sequela of prior insult. 2.Numerous meningiomas or meningiomatosis, predominantly supratentorial, are very minimally increased compared to the previous examination of October 2014. 3.Similarly, the bilateral vestibular schwannomas are minimally increased compared to the previous examinations of October 2014 and May 2013. 4.Hemosiderin staining along the right frontal ventriculostomy remains unchanged. There is no acute hemorrhage.