Reason: any change in glioma or any other tumors or abnormalities noted History: NF type 1, optic glioma. MRI brain:The CSF spaces are appropriate for the patient's stated age with no midline shift. There is no evidence of intracranial hemorrhage. No foci of diffusion restriction are appreciated.There are subtle T2 hyperintensities in the thalami bilaterally and pons. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus. Mild mucosal thickening of the ethmoid and maxillary sinuses is present.MRI orbits:The eyeballs are intact. There is redemonstration of enhancement and thickening of the orbital, canalicular and prechiasmatic left optic nerve. Distribution is similar to the prior exam. It measures up to 5 mm in thickness on the current exam. Given the differences in technique a direct comparison in size in thickness with the prior exam would be less accurate, however, there does not appear to be a substantial change in the thickness of the lesion. The extraocular muscles are intact. The lacrimal glands are symmetric and within normal limits in size and configuration. The suprasellar cistern is intact .No lesions involving the right optic nerve are appreciated.
1.A lesion involving the left optic nerve suspicious for an optic glioma is likely unchanged from the prior exam. This lesion is better visualized on the current exam, which is likely due to dedicated orbit imaging, and subtle changes may not be appreciated. No new lesions are present.2.Areas of increased T2 signal in the basal ganglia and pons likely represent focal areas of signal intensity (FASI), commonly associated with NF1. These were also present on the prior exam.