Tuberosclerosis. Complex partial seizures (epilepsy). Multiple findings compatible with the known diagnosis of tuberous sclerosis including cortical/subcortical tubers and transmantle T2/FLAIR hyperintense lesions as well as the multiple subependymal nodules, which show susceptibility effect probably from calcification, remain unchanged. Some of these subependymal nodules show suggestion of mild contrast enhancement. No definite lesions are identified at the foramina of Monro. Otherwise, there is no abnormal contrast enhancement. There is asymmetric enlargement of the right temporal horn which is associated with mild hippocampal volume loss but no definite increased T2 signal. The ventricles and other CSF-containing spaces are unchanged. There is no midline shift or brain herniation. The tiny serpentine vascular flow voids in relation to the posterior aspect of the left cingulate sulcus remain unchanged and may reflect a dural arteriovenous fistula. The major intracranial vascular flow voids are preserved, reflecting gross patency.There is no gross orbital abnormality. Maxillary sinus retention cysts as well as ethmoid and sphenoid mucosal thickening on the sympathetic chain since the previous examination. There is no destructive skull lesion. A prominent left lateral retropharyngeal lipoma is partially included and was present previously. It causes mild-to-moderate mass-effect on the nasopharynx.
1.Findings compatible with the diagnosis of tuberous sclerosis remain unchanged since the previous examination of March 2014. No definite MR evidence of SEGA.2.Volume loss without increased T2 signal involving the right hippocampal head remain unchanged. 3.Small serpentine vessels along the posterior aspect of the left cingulate sulcus probably reflect dural arteriovenous fistula which is unchanged.