Neuro_MR_Orbits: 58 M, progressive vision loss.

MRI ORBITS WITH AND WITHOUT CONTRAST:

 

CLINICAL HISTORY: 58 years of age, Male, with progressive vision loss in the left eye.

 

FINDINGS:

 

Orbits: T2 hyperintense, enhancing mass is seen which causes parallel thickening and enhancement involving the intracanalicular and intraorbital segments of the left optic nerve sheath. There is no abnormal enhancement left optic nerve. Normal appearance of the globe and extraocular muscles.

 

Normal appearance of the right globe, right extraocular muscles, right optic nerve and apparatus. No mass or abnormal enhancement is seen in the right orbit.

 

Soft tissues: Normal cavernous sinuses and visualized extracranial soft tissues.

 

Visualized skull base foramina: Normal.

 

Visualized paranasal sinuses: Bilateral maxillary sinus mucosal thickening, left greater than right

 

Mastoid air cells: Clear.

 

Bones: Normal.

 

Brain parenchyma: Nonspecific periventricular and subcortical T2/FLAIR white matter hyperintensities are seen, not significantly 

changed compared to prior examination.

 

Ventricles and extra-axial spaces: Appropriate for age.

 

Additional comment: Incidentally noted 2 mm enhancing focus in the left internal auditory canal fundus.

 

IMPRESSION:

 

1. Enhancing mass is seen which causes parallel thickening of the left optic nerve sheath as described above likely representing an optic nerve sheath meningioma, possibly increased in size from the prior exam.

 

2. Incidentally noted small enhancing focus in the left internal auditory canal which may represent a small vestibular schwannoma.

 

3. Nonspecific, periventricular and subcortical T2/FLAIR white matter hyperintensities, not significantly changed compared to prior 

examination.

(Optic nerve sheath meningioma)