Neurofibromatosis, type 1 with moyamoya and brainstem mass.. There is an unchanged heterogenously enhancing mass centered within the right midbrain, which measures 22 AP x 20 RL x 18 SI mm. There is no evidence of intracranial hemorrhage or acute infarct.. There is unchanged encephalomalacia with subcentimeter cystic defects in the left frontal deep and periventricular white matter and within the right temporal occipital region. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. There are postoperative findings related to bilateral pial synangiosis. There is steno-occlusive disease involving the internal carotid arteries with associated collateral vessels. There is a probable right basal ganglia developmental venous anomaly. There is a partially-imaged left cleft palate and associated postoperative findings.
1. Unchanged right brainstem mass, accounting for differences in technique.2. Unchanged areas of encephalomalacia in the left frontal deep and periventricular white matter and within the right temporal occipital region are compatible with chronic infarcts. No evidence of acute cerebral infarction.3. Postoperative findings related to bilateral pial synangiosis and steno-occlusive disease involving the internal carotid arteries are better depicted on the prior MRA. .