Presentation
Visual disturbances.
Patient Data
The MRI sequences demonstrate:
enlargement of the intracranial prechiamatic segment of the optic nerves (more on the right) as well as the optic chiasma and optic tracts showing an isosignal to the cortical grey matter on T1 and T2, high signal FLAIR with no enhancement on postcontrast sequences.
abnormal high signals on FLAIR, and T2 with no enhancement of the cerebellum, brainstem (mainly midbrain), pallidi, left thalamus and the left internal capsule, representing most likely focal areas of signal intensity (FASI)
Case Discussion
The association of optic pathway gliomas and focal areas of signal intensity (FASI) are highly suggestive of neurofibromatosis type 1.
FASI areas are the most common neuroimaging feature in NF1 patients. They most commonly occur in the basal ganglia, brainstem, thalamus, optic tracts, cerebellum, and infrequently cerebral hemispheres.
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