Cerebral cyst, follow-up evaluation. Also bilateral leg and arm pain with hot/cold paresthesias, particularly involving the lower legs, no specific distribution. Brain MRI:There has been no significant change of a large extra-axial CSF signal intensity lesion overlying the left frontal, temporal and parietal lobes. It again measures 5.3 x13.4 cm in the transverse and oblique AP dimensions at the level of the foramen of Monroe, when measured in the same locations utilized previously. Overall, there is now less left hemispheric mass effect as best evidenced by slightly decreased left lateral ventricular effacement, and a decrease in left-to-right midline shift (measuring 1-2 mm, previously 5 mm). This is presumed secondary to an increase in overall calvarial vault growth and volume, combined with stable mass dimensions. There is outward convexity of the calvarium over this lesion similar to prior. There remains some superior displacement of the distal left MCA branches. There are no other acute new abnormalities including any additional intracranial mass or fluid collection. There is no diffusion abnormality. Mastoid air cells are clear. Complete spine MRI:Alignment is anatomic. There are no fractures or subluxations. The marrow signal is benign. The cord is normal in signal. The cervicomedullary junction is normal. The cerebellar tonsils are in normal position. The conus is normal in signal and morphology and terminates at L2. Upon prone imaging, the conus and cauda translate anteriorly. The visualized paraspinal contents are unremarkable. There are no segmentation anomalies.
1.There has been no significant change of a large extra-axial CSF signal intensity lesion overlying the left frontal, temporal and parietal lobes. Overall, there is now less left hemispheric mass effect as best evidenced by slightly decreased left lateral ventricular effacement, and a decrease in left-to-right midline shift (measuring 1-2 mm, previously 5 mm). This is presumed secondary to an increase in overall calvarial vault growth and volume, combined with stable mass dimensions.2.Negative complete spine MRI without cord signal abnormality, fatty filum, Chiari malformation, tethered cord, or segmentation anomaly.