 Distended optic nerve sheaths are seen with mild bulging of the optic nerve heads particularly on the right compatible with papilledema. No abnormal mass within the orbits is appreciated. Evidence of left-sided intraocular lens replacement. Left maxillary mucus retention cyst and minimal mucosal thickening in the ethmoid sinuses. No convincing signal abnormality within the optic nerves themselves is appreciated. There is enhancement surrounding the optic nerve sheaths bilaterally without discrete mass.Partially imaged brain again demonstrates Ommaya catheter with tip in the lateral aspect of the lateral ventricle. CSF signal intensity collection surrounding the catheter appears similar with surrounding vasogenic edema. Moderate ventriculomegaly appears similar. T2/FLAIR hyperintensity in the periventricular white matter also appears similar. Partially empty sella is noted which can be normal variant.CERVICAL SPINE
1. MRI of the orbits demonstrates bulging of the optic nerve heads suspected to represent papilledema. There is enhancement surrounding the optic nerve sheaths bilaterally which is nonspecific and may be related to perineuritis, possibly from treatment-related change or perhaps related to known leptomeningeal disease. No edema within the optic nerves. No discrete orbital masses.2. Limited evaluation of the brain again demonstrates dilatation of the ventricular system. Although some of this is related to volume loss, mild communicating hydrocephalus is suspected.3. Diffuse abnormal leptomeningeal enhancement involving the cauda equina nerve roots and surface of the lower thoracic cord. This finding is similar to prior and compatible with history of leptomeningeal disease. No evidence of epidural tumor or masses. No cord signal abnormality.