Neurofibromatosis type I, evaluate for change in glioma and right medullary mass. Again noted is nonenhancing expansile T2/FLAIR hyperintense mass within the right dorsal medulla. This continues to measure 12 x 13 mm on 801/19, unchanged from the most recent comparison. However, comparing back to the baseline exam, there appears to be decreased extent of involvement in the right upper cervical cord as well as the right ventral medulla.There is redemonstration of multiple foci of nonenhancing nonenhancing T2/FLAIR hyperintensity within the within the globus pallidus bilaterally, with less well-defined abnormal signal extending into the right cerebral peduncle. The lesions in the left global globus pallidus again appears slightly larger, more confluent and conspicuous compared to prior while the remaining lesions are not significantly changed. Similarly, nonenhancing T2 foci in the right greater than left cerebellar hemispheres are again seen, with perhaps slight decreased confluence of abnormal signal on the right especially when comparing back to more remote exams.There is persistent enlargement of the cisternal left optic nerve measuring up to 14 mm, which appears minimally progressed since the previous exam where it measured 13 mm, with also increased confluence of abnormal enhancement now measuring 1.4 x 1.3 cm in greatest axial dimensions.Ventricles and sulci are stable. Mild mucosal thickening is noted within the sphenoid and maxillary sinuses.
1. Further slight interval increase in overall size and degree of confluence of enhancing component of the patient's known left optic nerve glioma. 2. Redemonstration of nonenhancing FASI, presumably related to neurofibromatosis. Slight interval further increase in size and confluence of the lesions in the left basal ganglia. Slight interval decreased prominence of abnormal signal in the right The remaining lesions are not significantly changed.3. No significant interval change in nonenhancing expansile right dorsal medullary mass compared to more recent exams, although overall decreased ventral and caudal extent compared to more remote exam.