Male, 75 years old, with probable Alzheimer's disease and multiple hemangioblastomas. Evaluate for change. Sequelae of prior right frontal craniotomy and prior posterior fossa surgery are again seen. Enhancing dural thickening and tumor nodularity along the anterior interhemispheric falx is demonstrated. Likewise, multiple enhancing nodules within the posterior fossa and the upper cervical spinal cord are again seen. The size of these enhancing lesions has not significantly changed when compared to the immediate prior examination but has increased relative to the older examination of 7/29/2015. Likewise, the associated edema is unchanged from the immediate prior but progressed relative to the older study. rCBV mapping shows elevated blood volume within the enhancing lesions and in the immediate surrounding parenchyma.Within the limitations of a motion degraded examination, no definite evidence of any new enhancing lesion is seen. No restricted diffusion is evident. Scattered small foci of white matter T2 hyperintensity are unchanged and nonspecific, perhaps representing microvascular ischemic disease. No acute intracranial hemorrhage or any abnormal extra axial fluid collection is suspected. The ventricles are stable in size.
Findings compatible with hemangioblastomatosis are again seen including dural tumor studding along the anterior interhemispheric falx and numerous enhancing nodules within the posterior fossa. Relative to the immediate prior examination, there has been no significant interval change. Compared to an older examination, increased tumor size and progressive edema are noted.