Neurofibromatosis type II. Sensory changes in the right hand and decreased thenar eminence. Decreased hearing and more balance problems. BRAIN MRI:Numerous intracranial meningiomas are present, compatible with the known diagnosis of neurofibromatosis type II. Few have increased in size, while most of the lesions remain unchanged. The largest of these is a right-sided anterior falcine meningioma which measures axially 2.3 cm x 2.1 cm compared to 1.8 cm x 1.6 cm. A convexity meningioma overlying the left sylvian fissure remain unchanged and measures in the axial plane 2.2 cm x 1.2 cm compared to 2.2 cm x 1.1 cm previously. A meningioma at the level of foramen Magendie has very minimally increased in size, if any. In the sagittal plane, it measures 1.3 cm x 0.6 cm compared to 1.0 cm x 0.6 cm. A right occipital parasagittal meningioma that previously measured 1.7 cm now measures 1.8 cm. It does mildly compress the adjacent posterior part of the superior sagittal sinus though it remains patent. Multiple other similar parasagittal meningiomas are also present and do mildly compress the superior sagittal sinus without occluding it. An apparent filling defect in the lateral aspect of the right transverse sinus is unchanged and likely represents incidental arachnoid granulation. Apart from mild mass-effect by the meningiomas, the brain parenchyma is unremarkable. There is no acute infarct or intracranial hemorrhage. There is no ventricular dilatation. There is no midline shift or brain herniation. There is an unchanged, small mass involving the right orbital apex, which probably represents an optic sheath meningioma. .INTERNAL AUDITORY CANAL MRI:Lobulated contrast enhancing masses expanding the internal auditory canals remain not significantly changed since the previous examination, including the previous MRI of the IAC from October 2012. The involvement is much more extensive on the right. Involvement of the genu of the facial nerve is also not significantly changed, more pronounced on the right.CERVICAL SPINE MRI:Multiple contrast enhancing lesions within the cervical spinal cord have progressed since November 2013. The lesion at C3 level shows the most significant size progression and now measures up to 1.5 cm, compared to 0.8 cm. The adjacent lesion at C4 level, which was previously the largest and shows cystic change, has not significantly changed in size and still measures up to 1.2 cm but most of the other smaller lesions have increased in size. For example, the one at C6 level measures 8 mm compared to 5 mm previously. The associated cord expansion and central T2-hyperintensity has also progressed and now extends from C1-C2 level to the C5-C6 level. The small left posterolateral extramedullary lesion at the level of C2 has not changed. A small extramedullary mass at the left dorsal C6 levels also unchanged. There is sagittal straightening. Shallow ventral indentation of the thecal sac by the C6-C7 disc-osteophyte complexes is not significantly changed. The spinal canal is otherwise preserved.
1.Numerous intracranial meningiomas. Few have increased in size but most of them remain unchanged as described above. The parasagittal meningiomas mildly narrow the superior sagittal sinus, but it remains patent. 2.Mild progression of the multiple cervical spine intramedullary masses, most likely ependymomas.3.Unchanged cervical extramedullary intraspinal masses at C2 and C6 levels, which may represent schwannomas. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.