Diagnosis: Tuberous sclerosisClinical question: Please re-eval for tubers, SEGAs, other abnormalities with tuberous sclerosisSigns and Symptoms: tuberous sclerosis, childhood epilepsy The CSF spaces are appropriate for the patient's stated age with no midline shift. The patient is status post left frontal craniotomy. There is a CSF tract extending through the left frontal lobe into the left frontal horn surrounded by T2/FLAIR signal hyperintensity and local volume loss. A focus of punctate susceptibility is present at the left frontal horn adjacent ot the foramen of Monro.Foci of cortical signal hyperintensity of FLAIR MRI are present in the left frontal lobe at the left middle and inferior frontal gyri, left post central gyrus, right frontal lobe including superior frontal gyrus, right inferior parietal lobule, right middle temporal gyrus, left middle temporal gyrusNo abnormal mass lesions are appreciated intracranially. 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 mucosal thickening in the right maxillary sinus. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.Multiple cortical tubers.2.Status post left frontal horn and frontal lobe surgery. Please correlate with clinical history.3.Left ventricular ependymal lesion may represent a small subendymal nodule versus post surgical effect.