11-year-old male with mosaic neurofibromatosis and bilateral optic nerve gliomas s/p chemotherapy experiencing visual loss, right eye, unchanged from prior Redemonstrated is an oval T2/FLAIR hyperintense lesion along the right optic tract, extending inferiorly into the mesial right temporal lobe, unchanged in appearance on noncontrast techniques. There has been interval resolution of previously demonstrated enhancement.As before, there is a nonenhancing T2/FLAIR hyperintense and T1 hypointense lesion in the left optic chiasm/hypothalamus which has not significantly changed since prior exam.The ventricles and sulci are within normal limits. The cisterns remain patent. There is no midline shift or mass effect. There are no areas of new pathological enhancement. There is no diffusion abnormality. No extra-axial fluid collection is identified. Smaller foci of T2/FLAIR hyperintensity along the more posterior portions of the bilateral optic tracts are again noted, unchanged in appearance.Redemonstrated is an oval mildly peripherally enhancing right orbital segment optic nerve lesion with central cystic appearance, unchanged in appearance. Orbital structures are otherwise unremarkable. As before, there is mild scattered mucosal thickening within the paranasal sinuses without air-fluid level. Mastoid air cells are clear. Expected vascular flow voids are demonstrated.
1.Redemonstrated is an oval T2/FLAIR hyperintense lesion along the right optic tract, extending inferiorly into the mesial right temporal lobe, unchanged in appearance on noncontrast techniques, although there has been interval resolution of previously demonstrated enhancement.2.Other presumed bilateral optic pathway gliomas are stable.