 There are foci of T2 hyperintensity within the white matter, periventricular and subcortical. There are also small foci of T2 hyperintensity involving gray matter cortices of the left parietal lobe. These findings are unchanged.Redemonstrated is an enhancing lesion involving the left cavernous sinus, anterior clinoid and planum sphenoidale, extending along the petroclival ligament and floor of the anterior cranial fossa. The mass extends into the basilar cisterns. It abuts and displaces the optic chiasm and pituitary infundibulum and extends to the optic canal and orbital apex where the optic canal is dilated. These findings are unchanged.A left frontal enhancing lesion with a broad dural base is again noted, resulting in adjacent vasogenic edema of the cortex, unchanged in size or shape. A small enhancing dural based mass is noted along the posterior leftward falx adjacent to the medial left post central gyrus, unchanged. There is no restricted diffusion to suggest acute ischemia. The ventricles are unchanged in size or shape without interval dilatation. The visual paranasal sinuses and mastoid air cells are clear. Expected vascular flow voids are demonstrated. MR imaging through the internal auditory canals demonstrates intracanalicular enhancement which extends along the facial nerve bilaterally to involve the geniculate ganglion as well as the adjacent horizontal portion of the facial nerve, diagnostic for facial nerve schwannoma. These are not significant changed in size or shape.Additionally, enhancing lesions are noted involving the hypoglossal canals bilaterally, larger on the left were abuts the left cerebellum with a 7 mm cystic component invaginating into cerebellar parenchyma. These are also stable in appearance.
1.No change in multiple meningiomas.2.No change of probable bilateral IAC facial nerve schwannomas, although a separate additional component of vestibular schwannoma cannot be excluded.3.No change in bilateral hypoglossal canal schwannomas.