Tuberous sclerosis complex. There is interval decrease in size of the lobulated enhancing mass with areas of susceptibility effect in the left lateral ventricle, which measures up to 32 mm, previously 40 mm. There is persistent mild vasogenic edema in the surrounding brain parenchyma. There is also an enhancing mass within the right lateral ventricle, which measures up to 8 mm, previously 14 mm. There is slightly decrease prominence of the lateral ventricles, which are mildly dilated, and slightly increased diffuse periventricular white matter T2 hyperintensity. There is no significant interval change in numerous foci of subcortical T2 hyperintensity. There is no evidence of intracranial hemorrhage or acute infarct. There is a right cerebellar hemisphere developmental venous anomaly. There is no midline shift or herniation. The skull and extracranial soft tissues are unremarkable. There is persistent mild scattered paranasal sinus mucosal thickening. There is new left tympanomastoid fluid.
1. Interval decrease in size of bilateral lateral ventricular subependymal giant astrocytomas, left larger than right.2. Other stigmata of tuberous sclerosis are not significantly changed.3. New left tympanomastoid fluid may represent otomastoiditis.