 Redemonstrated is a heterogeneous T2/FLAIR hyperintense lesion within the cerebellar vermis, with areas of intrinsic T1 shortening and several foci of susceptibility artifact corresponding to previously noted calcifications as well as minimal patchy enhancement. Mild mass effect on the posterior wall of the fourth ventricle is again noted, without associated hydrocephalus. The mass is best delineated on the T2-weighted images. It currently measures 2.4 cm transverse x 3.0 cm AP on 401/9, likely without significant interval change when compared to more remote exams provided differences in technique and angulation.Low-lying cerebellar tonsils again extend 7 mm below the foramen magnum without peg-like appearance. There is moderate crowding. No evidence of diffusion restriction or midline shift. No new pathological enhancement is identified. There is no extra-axial fluid collection. Normal flow voids are identified in the major intracranial vessels. There is mild mucosal thickening in the maxillary sinuses.
1. No significant interval change in heterogeneous midline cerebellar vermian lesion with foci of calcification and enhancement with unchanged differential.2. Stable low lying but rounded cerebellar tonsils, possibly relating to the mass effect from the cerebellar vermian lesion. Please correlate clinically