Female, 10 years old, history of tuberous sclerosis and epilepsy. Image quality is degraded by motion artifact. Within this limitation, the following observations are made.Redemonstrated are numerous stigmata of tuberous sclerosis, including scattered areas of subcortical T2 hyperintensity and numerous ependymal nodules. Most of these lesions show no significant interval change. Some of the ependymal lesions seem to demonstrate minimal enhancement above their intrinsic T1 hyperintensity, but this has not appreciably changed.One lesion, however, within the left anterior temporal lobe, shows increased T2 signal and enhancement, now measuring up to 8 mm in diameter, previously 5 mm.No entirely new parenchymal lesions are seen. No evidence of significant mass effect is demonstrated. Ventricular size and morphology are unremarkable. No evidence of intracranial hemorrhage or any abnormal extra axial fluid collection is seen.Since the prior examination, maxillary sinus inflammation has improved. However, progressive opacification of the mastoid air cells and the left petrous apex is noted.
1.Interval increase in size of an enhancing lesion within the anterior left temporal lobe, the nature of which is uncertain. Although this would be a very unusual location for a giant cell astrocytoma, the possibility of a neoplastic process cannot be entirely excluded. Correlation with clinical symptomatology and close interval follow-up is suggested.2.The remaining subcortical tubers and subependymal nodules show no significant interval change in size or imaging characteristics.