0:01

This is an adolescent with neurofibromatosis type 2.

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We can see the classic bilateral vestibular schwannomas,

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and enhancing lesion filling and

0:09

slightly expanding the internal auditory canal,

0:12

extending through the porus acusticus

0:14

into the cerebellopontine cistern.

0:16

You see it, the lesion on the right here.

0:19

Now, we see bilateral cavernous sinus lesions,

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right greater than left.

0:23

These very likely are meningiomas.

0:28

Now, this patient also has a meningioma

0:30

here on the anterior skull base.

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A meningioma on the left side, and then this very

0:37

large anterior parafalcine meningioma.

0:41

So, this shows that neurofibromatosis type 2

0:45

can have a variety of manifestations.

0:50

And in this patient, the vestibular schwannomas,

0:53

are small and from a mass effect standpoint,

0:58

are not causing an issue.

1:01

And at the time of this scan,

1:03

the patient was not having any noticeable hearing

1:06

deficits on their audiogram surveillance.

1:10

But they've already had meningiomas resected, and

1:14

this is a surgical planning study before resection

1:17

of this interhemispheric parafalcine meningioma.

1:22

Now, this patient in the past had had a cervical

1:27

medullary intradural medullary lesion that was,

1:34

in the setting of neurofibromatosis type 2,

1:37

you would think ependymoma, all comers, you would

1:40

wonder in an adolescent about an astrocytoma.

1:45

But in this patient after resection,

1:48

it was confirmed to be an ependymoma.

1:51

We can see the postoperative appearance

1:53

here where they resected the lesion.

1:56

And we can see the fixation hardware

2:01

after the laminectomies, and we can see

2:05

a slight kyphosis here, which the fixation hardware,

2:10

the goal of that is to hopefully

2:12

prevent progression of a kyphosis.

2:14

This is a patient with neurofibromatosis type 2,

2:18

where their primary manifestations

2:22

requiring surgical intervention were

2:24

the meningiomas and ependymomas.

2:27

And the schwannomas, these bilateral

2:30

vestibular schwannomas, at the present time,

2:33

were stable and did not require intervention.