16-year-old female with a history of lymphoma and C. Diff presenting with facial swelling, CNVII deficit, and toe walking on exam. Evaluate meninges and white matter to rule out possible structural etiology, special attention to CN VII. MRI Brain:There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma and pituitary gland appear unremarkable. There is no evidence of abnormal enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.MRI IACs:The bilateral cranial nerve 7 and 8 complexes are intact. There is no evidence of mass lesions. The inner ear structures, including the cochlea, vestibule, endolymphatic duct, and semicircular canals, appear unremarkable. The bilateral mastoid air cells and middle ears also appear unremarkable.
No evidence of acute intracranial hemorrhage, mass, or acute infarct. No abnormality of the IACs is appreciated.