Section Editor: Sandy Cheng-Yu Chen, M.D.
Taipei Medical University Hospital, Taipei, Taiwan
Optic nerve gliomas usually manifest in the first decade of life and represent the most common intraconal tumor of childhood. Most so-called optic nerve gliomas are histologically juvenile pilocytic astrocytomas, WHO grade I. More than half of the cases have neurofibromatosis type 1 (NF-1), and it is the most common CNS neoplasm in NF-1. In our case, fusiform enlargement of both optic nerves, left more than right, is seen on coronal T2W fat sat (A, arrows), with intense enhancement on postgadolinium T1W fat sat images (B, arrows). Associated focal areas of signal intensities (FASIs) are seen in basal ganglia and thalami (C, arrows), which is typically seen in childhood NF-1, but not in adult patients.