23 year-old male with tuberous sclerosis and seizures, evaluate for growth of subependymal giant cell astrocytomas. Redemonstrated are bilateral enhancing giant cell astrocytomas at the level of foramina of Monro, multilobed on the left, which appear stable in size, signal intensity and pattern of enhancement compared to the 2 prior exams. Although precise measurements of these lesions at exact same location is difficult due to lesion morphology, the overall sizes appear very similar to the prior study.Previously noted left subependymal enhancing lesion at the level of the body of the left lateral ventricle is also stable.A large irregularly shaped calcific and enhancing left occipital and posterior temporal lobe with associative parenchymal volume loss also appears unchanged in signal intensity, overall morphology and pattern of enhancement to the prior study.Multiple additional smaller subependymal enhancing lesions in bilateral ventricle are all again measured with no appreciable change since prior study.Diffuse signal abnormality of the cortex and subcortical white matter of bilateral cerebral hemispheres without enhancement and consistent with sequela of tuberous sclerosis with no new definite foci.The visualized paranasal sinuses and mastoid air cells are clear.Overall morphology of the cortical sulci and ventricular system which are mildly dilated is very similar to the prior exam however unchanged in extent.
Stable extensive findings of tuberous sclerosis including bilateral subependymal giant cell astrocytomas.