NF1 with worsening headaches who has a tectal glioma. There is an unchanged ill-defined non-enhancing T2 hyperintense lesion in the periaquaductal region of the midbrain, which measures up to approximately 11 mm. While there appears to be narrowing of the aqueduct of Sylvius, the ventricles are unchanged in size and configuration. There is no evidence of intracranial hemorrhage or acute infarct. There is no abnormal intracranial enhancement. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable. There may be a partially imaged left parapharyngeal neurofibroma.
Unchanged presumed glioma in the midbrain, without evidence of hydrocephalus.