 There is redemonstration of the expansile T2 hyperintense cystic appearance of the optic chiasm, without significant interval change. Asymmetric thickening extends from the chiasm anteriorly into the cisternal and intracanalicular segments of the left optic nerve. There continues to be asymmetric FLAIR hyperintensity within the left optic tract thinning posteriorly.There is again a stable 4 x 3 mm T2 hyperintense focus just lateral to the left hypothalamus (1201/5) with corresponding enhancement. Retrospectively, this lesion does appear present on the exam from 3/20/2014 on prior 1301/1 and 1501/1, although it now appears slightly more prominent compared to the more remote exam.Partially cystic and partially solid enhancing pineal lesion is unchanged compared to previous examination.The left mastoid air cells have essentially cleared, although there is now mild-moderate patchy fluid opacification of the inferior right mastoid air cells. There is mild mucosal thickening in the maxillary sinuses bilaterally.
Continued stable appearance of left greater than right optic pathway glioma.Stable appearance of more recently recognized punctate enhancing lesion with T2 hyperintensity just lateral to the left hypothalamus, possibly more prominent than exam from March 2014 although only partially visualized at that time. Continued follow-up is recommended.