 Postcontrast images are limited by patient motion. Patient's dental hardware has been removed and previous susceptibility artifact along the anterior aspect of intracranial structures is no longer present. Focal susceptibility along the lateral aspect of the mid left ventricular body appears similar to prior exam, demonstrating corresponding minimal nodular enhancement, with a more punctate focus along the right lateral atrial margin. An additional focus of susceptibility is seen along the left foramen of Monro, with minimal corresponding peripheral enhancement measuring 4 mm, unchanged. An additional punctate nodular focus of enhancement is seen along the right lateral aspect of the foramen of Monro on 5/86, appearing unchanged.Thre are scattered foci of T2/FLAIR hyperintensity within the white matter, which along the right centrum semi-ovale and lateral left frontal lobe appear to represent radial fiber gliosis. In addition, there are scattered patchy areas of intrinsic T1 hyperintensity within the subcortical white matter consistent with subcortical tubers.There is moderate mucosal thickening in the left maxillary sinus, with trace thickening in the right. There is focal prominence of the extra-axial space along the anterior left frontal lobe on 7/18, although appearing similar to prior exam. Incidental small pineal cystic lesion with peripheral enhancement appears stable.
Stable stigmata of tuberous sclerosis, with enhancing nodules demonstrating corresponding susceptibility along the lateral ventricular margins, including at the left foramen of Monro. These likely represent subependymal nodules, without definite SEGA at this time, although close follow-up is recommended.