 There is stable ill-defined patchy T2/FLAIR hyperintensity along the medial right basal ganglia and the right frontal lobe medial orbital gyrus posterior aspect. There is no significant residual enhancement in this area. Previously seen FLAIR hyperintensity along the cerebellar tonsils in September 2015 is not appreciated, unchanged since July 2016 scan. The previously noted enhancement along the left optic nerve is not seen. A subtle area of ill-defined somewhat branching pattern enhancement in the proximal right precentral sulcus (series 51, image 25) without associated abnormal FLAIR signal intensity nor mass effects are seen. This lesion appears unchanged since prior examination thus may represent adjacent cortical vein enhancement. There is a stable right frontal approach Ommaya catheter with its tip in stable position along the right foramen of Monro. Ventricular caliber is unchanged.There is trace mucosal thickening in the right maxillary sinus and in scattered ethmoid air cells bilaterally. Flow-voids within the major intracranial vascular structures are present.SPINE MRI:There is no evidence of pathological enhancement within the thecal sac.There is reversal of the normal cervical lordosis, as well as straightening of the normal thoracic kyphosis and lumbar lordosis. There is no significant subluxation within the spine, with stable minimal grade 1 anterolisthesis of C2 on C3. The vertebral body and disc heights are stable, with multilevel degenerative changes most conspicuously involving the cervical spine although with only up to mild central spinal canal stenosis. No marrow signal abnormality is appreciated, other than scattered endplate degenerative marrow changes especially at L2-L3. The spinal cord is of normal caliber and signal. There is up to scattered moderate foraminal narrowing in the lumbar spine as well as scattered moderate severe foraminal narrowing within the cervical spine.
1. Stable examination with persistent ill-defined abnormal T2/FLAIR signal involving the medial right basal ganglia and right frontal lobe medial orbital gyrus posterior aspect.2. No evidence of leptomeningeal disease within the spine.