17 years Female (DOB:12/24/1998)Reason: compare to immediate post op scan; has the cyst reaccumulated in the brainstem? History: girl with NF2 who had brainstem ependymoma and surgery in Feb.PROVIDER/ATTENDING NAME: JAMES H. TONSGARD JAMES H. TONSGARD The patient is status post suboccipital craniotomy. There is a 32 x 21 mm sagittal dimension partially cystic mass located at the cervical medullary junction which measured 24 x 36 mm sagittal dimensions on the 2/3/2016 exam.. There is redemonstration of an enhancing nodule measuring 9 x 7 mm sagittal dimensions located at the cervical spinal cord at the C3 vertebral level. This is unchanged since previous exams.There is redemonstration of an enhancing mass within the left internal auditory canal measuring 9 x 6 mm mm axial dimensions which previously measured approximately the same. There is redemonstration of a right internal auditory canal measuring measuring 12 x 7 mm axial dimensions previously measuring 11 x 7 mm axial dimensions.The left cavernous sinus is larger than the right cavernous sinusThere is redemonstration of a mass in the left orbit currently which surrounds the left optic nerve and measures 19 x 29 mm axial dimensions and previously measured approximately the same. It is associated with mild exophthalmos.There is redemonstration of a left suprasellar mass medial to the left temporal lobe measuring 14 x 10 mm axial dimensions which previously measured the same. There are small dural based nodules along the falx cerebri which are stable since prior exam.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.Findings are suggestive of neurofibromatosis type II. 2.Since the prior exam a mass at the cervical medullary junction has mildly decreased in size. Suspected represent an ependymoma.3.There are multiple extra-axial nodules suspected to represent schwannomas with bilateral acoustic schwannomas in the schwannoma in the left suprasellar cistern possibly third fourth or sixth nerve and possibly one in the left cavernous sinus which could also represent a meningioma..4.There is a stable mass located in the left orbit suspected represent a meningioma. There are additional extra-axial nodules identified along the dura which are also stable and likely represent small meningiomas.5.There is a spinal cord lesion present at the C3 level which is stable since the prior exam and is suspected to represent ependymoma based on clinical history.