Status post SEGCA. (tuberosclerosis) with complaints of severe headache and pain. Evaluate hydrocephalus. There is no evidence of intracranial hemorrhage. Multiple subependymal tubers are again seen consistent with history of tuberous sclerosis. Subependymal mass in the right frontal horn appears stable again measuring 2.2 x 2.9 cm (image 13), suspicious for a subependymal giant cell astrocytoma. Additional lower density mass in the frontal horn and body of the left lateral ventricle also appears stable and may represent a cystic component of the presumed giant cell astrocytoma versus an arachnoid cyst. An additional subependymal mass in the body of the left ventricle is also concerning for an astrocytoma. MRI is recommended for further evaluation. The ventricles are enlarged although unchanged compared with prior examination. The calvaria and skull base are radiographically normal. The visualized paranasal sinuses and mastoid air cells are normally pneumatized.
No interval change in bilateral subependymal masses and subependymal calcifications consistent with history of tuberous sclerosis with presumed giant cell astrocytomas. Stable ventricular volumes. MRI is recommended for further evaluation.