33 years Male (DOB:10/22/1982)Reason: S/P resection of brain lesion, hemingioblastomas of the brain and spine, yearly follow up History: 6 month follow upPROVIDER/ATTENDING NAME: DAVID M. FRIM DAVID M. FRIM MRI brain:There is redemonstration of multiple enhancing nodules scattered in the posterior fossa and to a lesser degree supratentorial brain. One located in the vermis associated with a cystic component has an enhancing component which measures 9 x 10 mm sagittal dimensions on the current exam than on prior exam the enhancing spine measured 11 x 10 mm. Another along the inferior aspect of the vermis currently measures 7 x 4 mm sagittal dimensions and previously measured 7 x 4 mm sagittal dimensions. One centered at the colossal sulcus currently measures 7 x 6 mm sagittal dimensions and previously measured 7 x 6 mm. Additional smaller nodules are scattered throughout the posterior fossa. There is associated FLAIR signal hyperintensity surrounding many of these lesions which was also present on the previous exam and has not changed substantially. Cystic components likewise are also stable.Patient status post posterior fossa surgery.A ventriculostomy tract course of the right frontal lobe to the right lateral ventricle.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 are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.MRI cervical spine:The cervical spinal cord is a distorted in the C3 vertebral body level inferiorly. There is abnormal signal centered in the right hemicord extending from the C3 vertebral body level down to the upper thoracic spine level. There is a heterogeneous lesion within the spinal cord centered at the T1 but extending from C7 down to T2. It measures approximately 41 x 8 mm sagittal dimensions and 11 x 8 mm axial dimensions. On the exam from 5/31/2015 and measured 8 x 11 mm axial dimensions and 41 x 8 mm sagittal dimensions. There are small associated enhancing foci located at the periphery of the spinal cord which are unchanged. One of these enhancing foci is at the C7 vertebral level at the right posterior lateral aspect of the spinal cord and measures 4 x 4 x 8 mm. Another is at the T1 level also on the right posterior lateral aspect of the spinal cord and measures 7 x 4 x 4 mm. A third enhancing focus is present along the left hemicord posterior laterally and measures approximately 3 mm.The cervical vertebral bodies are appropriate in overall alignment. There is reversal of the normal cervical curvature centered at C6 where there is a compression fracture. The patient is status post laminectomies at C4, C5 and C6. The patient appears to be status post right hemicord surgery in the lower cervical spinal cord.At C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there is no significant compromise to the spinal canal or neural foramina.At C4-5 there is no significant compromise to the spinal canal or neural foramina.At C5-6 there is no significant compromise to the spinal canal or neural foramina.At C6-7 there is no significant compromise to the spinal canal or neural foramina.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact.
1.Since the prior exam the patient's multiple posterior fossa lesions and corpus callosum lesion have remained stable. This cyst in the mural nodule appearance of a couple of these lesions suggest that these are most likely related to hemangioblastomas in the setting of von Hippel-Lindau disease.2.There is a spinal cord lesion centered at the cervicothoracic junction which appears stable compared to previous exam.3.There is a mild C6 compression fracture present with reversal of the cervical curvature.4.Patient status post cervical spine surgery.