NF1 and epilepsy, as well as scoliosis, status post correction with rods with constant mid back pain. Brain: There is enlargement of multiple segments of the optic nerves bilaterally, left more than right, with dilatation of the optic nerve sheaths. There is no evidence of intracranial hemorrhage or acute infarct. There is diffuse patchy T1 hyperintensity in the bilateral basal ganglia and thalami. There are also several small foci of high T2 signal in the medial portions of the cerebellum. The lateral ventricles are asymmetric, but not enlarged. However, there is prominence of the subarachnoid space in the anterior left middle cranial fossa measuring up to 10 mm in width, with associated anterior bowing of the overlying lateral orbital wall. A similar finding is present on the contralateral side, but to a lesser degree. There is no midline shift or herniation. The major cerebral flow voids are intact. The scalp soft tissues are unremarkable, but there is a small enhancing nodule in the left cheek skin and subcutaneous tissues.Spine: There is focal kyphosis at C5-6 with mild anterior wedge deformity of the C5 and C6 vertebral bodies. There also appears to be mild narrowing of the spinal canal at this level, but no spinal cord compression. There is no evidence of tumors in the cervical spine, although assessment is limited based on only the localizer images of this region. There are postoperative findings related to multilevel thoracolumbar scoliosis surgery. Metal artifact obscures surrounding anatomy, including the spinal cord and most of the vertebral bodies. There is moderate apex right thoracic and apex left lumbar scoliosis. There is a cerebrospinal fluid signal collection in the left paraspinal region that spans the lower thoracic and upper lumbar spine levels, with what appears to be associated enlargement of the adjacent neural foramina. There are numerous scattered subcutaneous nodules. There is also a more infiltrative lesion that is partly imaged in the left lateral lower back subcutaneous tissues.
1. Bilateral optic nerve gliomas, mild sphenoid wing dysplasia, and other stigmata of neurofibromatosis type 1 in the brain.2. Multiple cutaneous nodular neurofibromas and what may represent a large left lateral lower back superficial neurofibroma, although this is incompletely imaged.3. Focal kyphosis at C5-6 with mild anterior wedge deformity of the C5 and C6 vertebral bodies. 4. Postoperative findings related to multilevel thoracolumbar scoliosis surgery with persistent scoliosis, whereby metal artifact obscures surrounding anatomy. Nevertheless, what likely represents a large left thoracolumbar pseudomeningocele is partly discernible.