Girl with NF1 and markedly accelerated growth. Brain: There is unchanged enlargement of the bilateral optic nerve cisternal segments with sparing of the optic chiasm. There is persistent patchy T2 hyperintensity in the supratentorial and infratentorial deep grey matter. There is no evidence of intracranial hemorrhage or acute infarct. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. There is a newly apparent punctate focus of enhancement in the right temporal scalp, just posterior to the orbital rim.Orbits: There is unchanged diffuse expansion, T2 hyperintensity, and enhancement of the bilateral intraorbital optic nerve segments, measuring up to 6 mm in diameter on the left and 5 mm in diameter on the right. There is also unchanged expansion of the and canalicular optic nerve segments.
1. Unchanged optic nerve gliomas and intracranial stigmata of neurofibromatosis type 2.2. A newly apparent punctate focus of enhancement in the right temporal scalp, just posterior to the orbital rim, may represent a peripheral nerve sheath tumor.