Right optic nerve sheath atypical meningioma f/u exam, status post radiation therapy and three debulking surgeries. Orbits: Postoperative findings related to right optic nerve sheath meningioma subtotal resection are redemonstrated. What appears to be residual tumor in the posteronasal aspect of the right orbit, measuring up to 15 mm in the craniocaudal dimension and 14 x 14 mm in the axial dimension, is best seen on the coronal STIR sequence (series 1101, images 21 and 22). Artifact from hardware around the right orbit significantly limits evaluation. There is otherwise soft tissue deficiency in the right orbit with associated enophthalmos with diffuse enhancement of the intraorbital structures, which may represent post-treatment inflammation and/or scar tissue. The right optic nerve is deformed with diffusely increased T2 signal as before. The right globe is intact. The left orbital structures are normal. Brain: Remaining of the brain parenchyma is within normal limits. There are a few scattered nonspecific cerebral white matter T2 hyperintense foci. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift. The major cerebral flow voids are intact.
No significant interval change in findings related to right optic nerve sheath meningioma subtotal resection with what appears to be residual tumor that measures up to 15 mm in the posteronasal aspect of the right orbit and enophthalmos.