NF 2 with vestibular and cervical spine schwannomas. Brain: There are unchanged enlarged perivascular spaces in the left middle frontal gyrus with confluent surrounding T2 hyperintensity. There is a similar finding to a lesser extent in the right middle frontal gyrus. There are unchanged mildly low-lying cerebellar tonsils. The orbits, skull, and scalp soft tissues are unremarkable. There is no evidence of acute intracranial hemorrhage or infarction. There is no midline shift. Internal Auditory Canals: There has been interval increase in size of an enhancing extra-axial mass in the right internal auditory canal with extension through the porus acusticus into the cerebellopontine angle cistern, which now measures 12 x 16 mm in axial cross-section, previously 9 x 12 mm. There is mild mass-effect upon the adjacent right middle cerebellar peduncle and right cerebellar hemisphere. There has also been interval increase in size of an enhancing extra-axial mass in the left internal auditory canal, with slight extension medially through the porus acusticus, which now measures 6 x 9 mm in axial cross-section, previously 4 x 7 mm.Cervical Spine: There is an unchanged right anterolateral intradural, extramedullary, tubular, enhancing lesion at the C6-7 level that measures 6 x 2 mm in axial cross-section, which is unchanged. The vertebral column alignment is within normal limits. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is unremarkable. There is no significant spinal canal stenosis. The spinal cord displays normal signal and morphology. The paravertebral soft tissues are unremarkable.
1. The bilateral vestibular schwannomas have further increased in size.2. Unchanged prominent perivascular spaces in the bilateral middle frontal gyri, left greater than right, with what may represent surrounding gliosis. 3. Unchanged mildly low-lying tonsils.4. Unchanged presumed schwannoma at the C6-7.