Neurosarcoidosis with recent visual changes. Evaluate for any interim changes. Orbits: There is persistent enhancement and T2 hyperintensity of the orbital segment of the right orbital nerve. Otherwise, there has been interval resolution of enhancement and swelling of the rest of the right optic nerve, optic chiasm, and left optic nerve. The bilateral globes, extraocular muscles and orbital fat bilaterally appear unremarkable. There is an enhancing skin excrescence along the lateral aspect of the left lateral orbital rim that measures up to 5 mm. Brain: There has been interval resolution of the abnormal leptomeningeal enhancement. Furthermore, there has been marked interval decrease in the degree of abnormal perivascular enhancement. There is no evidence of intracranial hemorrhage, mass, or acute cerebral infarct. The brain parenchyma and pituitary gland appear unremarkable. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. There is a right maxillary sinus retention cyst. The skull and scalp soft tissues are grossly unremarkable.
1. Persistent abnormality of the orbital segment of the right orbital nerve related to neurosarcoidosis. Otherwise, the inflammation involving the rest of the right optic nerve, optic chiasm, and left optic nerve have resolved. 2. Interval resolution of the abnormal leptomeningeal and markedly decreased perivascular enhancement related to neurosarcoidosis. 