The previous year a brain MRI showed focal areas of signal intensity (FASI) in the cerebellum. Follow-up CT showed contrast enhancement of the cerebellum lesions.

Astrocytomas are seen in 1-3% of NF 1 patients. Common sites are brainstem/cerebellum and splenium of corpus callosum. These tumors have an earlier presentation, are more likely multicentric and are much less aggressive than their sporadic counterparts. MR Spectroscopy may show increased choline in both FASI and tumors, but NAA is near normal in FASI while tumors show decreased levels. Persistent enhancement and increasing size are worrisome features for tumors.