14 years Female (DOB:4/14/2002)Reason: history of NF1 and optic gliomas s/p chemotherapy History: off therapy evaluationPROVIDER/ATTENDING NAME: KELLY KRAMER RUTH RUDINSKY MRI brain:The CSF spaces are appropriate for the patient's stated age with no midline shift. There is redemonstration of signal abnormalities in the right cerebellum, left anterolateral medulla, dentate nuclei, right thalamus and the left thalamus without enhancement.No abnormal enhancing mass lesions are appreciated within the brain parenchyma. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses demonstrate mild mucosal thickening. The visualized portions of the mastoid air cells demonstrate some opacities. MRI orbits:There is a redemonstration of enlargement of the left optic nerve due to an optic nerve glioma which currently measures 7 x 8 mm coronal dimensions and 22 x 8 mm sagittal dimensions. This has not changed since the prior exam from August 2010. In general it has not changed in appearance since the past exam.There is redemonstration of a suprasellar mass extending along the chiasm and right optic nerve measuring 14 by 27 mm axial dimensions on the current exam and has similar dimensions on the August 2010 exam.The eyeballs are intact. No extraconal space mass is identified. The extraocular muscles are intact. The lacrimal glands are symmetric and within normal limits in size and configuration.
1.redemonstration of bilateral optic gliomas which are stable since the previous exam.2.Redemonstration of multiple lesions in the brain parenchyma within basal ganglia brainstem and cerebellum which are stable since prior exam and suspected represent hamartomatous lesions.3.No new lesions are identified in the brain parenchyma.4.Mucosal thickening in the paranasal sinuses and partial desiccation of the mastoid air cells. This was also present on the prior exam.