14-year-old male with history of fibrillary astrocytoma status post chemotherapy. Evaluation off chemotherapy. MRI BRAIN: Redemonstration of a T2/FLAIR hyperintense intra-axial lesion within the medulla and cervicomedullary junction, which when measured carefully at multiple levels, appears to have mildly increased in size by a few millimeters. For example, the lesion now measures 20 mm x 17 mm (series 1501, image 33), previously 19 mm x 15 mm. This slight increase in size is more conspicuous when comparison is made to older exams. The lesion continues to demonstrate no enhancement. No new areas of abnormal signal or enhancement are identified. No acute intracranial hemorrhage. The ventricles and sulci are appropriate for patient age with no midline shift. The paranasal sinuses and mastoids are clear. The imaged orbits are unremarkable.MRI CERVICAL SPINE: There is reversal of the normal cervical lordosis, otherwise vertebral body heights and disc spaces are maintained. No abnormal marrow signal is identified. Spinal cord signal is normal except at the level of the cervical medullary junction. No abnormal enhancement is seen.
1. Very mild interval increase in caliber of the brainstem lesion is suspected without evidence of any new lesion or pathologic enhancement. The clinical significance of this finding is uncertain.2. Except as above, the cervical spine is within normal limits. 