History of tuberous sclerosis, SEGA, and seizure on Everolimus. Evaluate SEGA, and cortical tubers for interval change. Redemonstrated are extensive cortical and subcortical foci of increased T2 signal in the bilateral cerebral hemispheres, which are similar to prior study. There is a subtle ill-defined focus of low signal intensity on FLAIR and high T2 signal intensity on T2-weighted images in the inferior posterior aspect of the left cerebellar hemisphere without significant interval change, likely an additional stable parenchymal tuber. There is associated susceptibility artifact/calcifation and very subtle enhancement. Multiple subependymal enhancing nodules of varying size are again identified. An enhancing nodule/SEGA in the right frontal horn measures 11x9x10 mm, previously 13x8x9 similar to prior study. An enhancing nodule at the level of the trigone of the right lateral ventricle and along the ependymal lining of the posterior body of the left lateral ventricle are also similar in size allowing for differences in technique. These nodules are calcified as seen on prior CT.There is no evidence of intracranial hemorrhage or acute infarct. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. There is a mucous retention cyst in the right maxillary sinus. The skull and extracranial soft tissues are unremarkable.
1. Overall, stable stigmata of tuberous sclerosis including dominant enhancing nodule at the right frontal horn/foramen of Monro. This lesion may represent a subpendymal giant cell tumor but has not enlarged in the interval.2. No hydrocephalus.