21 years, Female, neurofibromatosis type I, cerebellar astrocytoma, hydrocephalus with VP shunt. Presenting with intermittent dull headaches. Susceptibility artifact related to right transparietal VP shunt catheter slightly limits evaluation. Ventricular system is well decompressed, similar to CT from 2/16/2012. Ventriculostomy catheter appears in unchanged position. There is no significant change in appearance of the masslike FLAIR hyperintensity corresponding to the known astrocytoma involving the left cerebellar hemisphere and extending into the vermis left greater than right. Unchanged mass effect including deformity of the fourth ventricle. Unchanged areas of susceptibility effect related to calcification and chronic blood products. Evidence of prior suboccipital craniectomy for partial tumor resection and volume loss primarily involving the right cerebral hemisphere similar to prior. No suspicious enhancement. Again seen is linear T2 hyperintensity involving the right frontal lobe related to prior right frontal ventriculostomy tract.No evidence of acute infarct, hemorrhage, new mass or new mass effect. Minimal mucosal thickening involving the paranasal sinuses. Mastoid air cells are clear. Diffuse fatty atrophy of the right muscles of mastication is again seen.
No significant change in infiltrating cerebellar mass compared to 11/30/2011 consistent with known residual cerebellar astrocytoma. Unchanged associated mass effect and deformity of the fourth ventricle. Ventricular system remains decompressed.