20-year-old with history of von Hippel-Lindau and prior brain/spinal hemangioblastomas. Evaluate for interval change. Motion artifact moderately limits the image interpretation, particularly within the spine Brain:Surgical changes from prior midline suboccipital surgery.Redemonstration of a nodule of enhancement along the midline dorsal medulla at the level of the foramen magnum is not significantly changed from prior measuring 5 mm, previously 5 mm.Redemonstration of 5 small enhancing nodules in the bilateral cerebellar hemispheres which are not significantly changed from prior. There is mild associated edema.Mild edema associated with the lesions is not significantly changed.Dedicated imaging of the temporal bones and internal auditory canal does not show any enhancing or destructive mass to suggest endolymphatic sac tumor. No lesions within the supratentorial brain are appreciated. No evidence of acute ischemia or hemorrhage. The ventricles and basal cisterns are normal in size and configuration. The expected intracranial vascular flow voids are present. Calvarium and extracranial soft tissues are grossly unremarkable.Cervical spine:The vertebral body and intervertebral disc heights are maintained. Straightening of the cervical lordosis is seen, alignment is otherwise maintained. No suspicious bone marrow signal abnormalities. Redemonstration of an intramedullary lesion in the posterior cervical cord at the C4 level which measures 10 mm in maximum dimension. This is previously reported as measuring 6 mm, however repeat measurement on the exam from 1/3/2015 using similar slice as on current measurement yielded a similar measurement of 10 mm. There is stable edema within the cord adjacent to this lesion. No new cervical cord lesion.No disc bulges, neural foraminal stenosis, or spinal canal stenoses in the cervical spine. Thoracic spine:There is stable mild straightening of the thoracic spine. Mild endplate irregularity which was also previously present from T9 through L1 with mild wedging deformities of the T10 and 11 vertebral bodies are unchanged. No evidence of acute fracture.Redemonstrated enhancing lesion in the right posterior cord at the T4 level measures 7 mm, previously 6 mm. Additional lesion in the right posterior cord at the T6 level measures 4 mm, previously 5 mm. These lesions are associated with mild cord edema appearing similar to prior.No significant disc bulge, spinal canal stenosis, or neuroforaminal narrowing. Lumbar Spine:The vertebral body and intravertebral disc heights are maintained. The alignment is anatomic. No bone marrow signal abnormalities.No enhancing masses are noted in the conus or cauda equina.No significant disc bulge, spinal canal stenosis, or neuroforaminal narrowing.
Accounting for differences in technique and motion degradation on some sequences, there is no appreciable interval change in multiple enhancing lesions in the bilateral cerebellar hemispheres, dorsal medulla, cervical spinal cord, and thoracic spinal cord which are compatible with hemangioblastomas. Associated edema is also not significantly changed. No new lesions or new edema is identified. There are also no findings to suggest endolymphatic sac tumor