Female, 11 years old, history of medulloblastoma status post craniotomy, radiation therapy and chemotherapy. Off therapy evaluation 33 months following completion of therapy. Brain:Findings related to prior surgery and treatment within the posterior fossa are again seen. The tumor resection bed, and associated encephalomalacia of the cerebellar hemispheres, are stable in appearance. A small area of enhancement measuring 6 x 4 mm along the right margin of the fourth ventricle is unchanged. No new suspicious enhancement is seen.Elsewhere in the brain, encephalomalacia affecting the right occipital lobe is stable. No new areas of signal abnormality or pathologic enhancement is detected. There are numerous foci of susceptibility artifact within the brain parenchyma and along the ventricular margins which are unchanged. Ventricles remain prominent but caliber and morphology are similar to that seen on the prior exam.Spine:Spinal cord morphology and signal characteristics are within normal limits. No evidence of pathologic intrathecal enhancement is seen.Fatty marrow replacement seen at some levels of the spine is compatible with prior radiation therapy. Otherwise, no concerning marrow signal abnormality or pathologic marrow enhancement is detected.Spinal alignment is anatomic. Vertebral body heights and morphology are within normal limits. No spinal canal or neuroforaminal stenosis is suspected.
1. Stable appearance of the posterior fossa treatment bed. This includes a small area of enhancement along the right margin of the fourth ventricle. No new lesions are detected.2. Evidence of prior radiation therapy is seen in the spine. No findings are evident to suggest metastatic disease.