Recurrence of ALL in brain: Right eye visual field deficit. Brain: There is no evidence of intracranial hemorrhage, mass, or acute infarct. There are scattered foci of cerebral white matter T2 hyperintensity. There is no abnormal intracranial enhancement. There is mild diffuse cerebral volume loss. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.Orbits: There is asymmetric protrusion of the right optic disc, as well as enhancement of the anterior right optic nerve. There is perhaps mildly elevated T2 signal in the affected portions of the right optic nerve. The rest of the right orbital contents and left orbit are unremarkable.
1. Enhancement of the right optic nerve with papilledema may represent leukemic involvement. Differential considerations may include drug reaction or other forms of optic neuritis.2. No evidence of intracranial mass. 