 Dr. Schupak, this is a 47-year-old woman who's got visual loss on the right side, and at our New York course at the Beacon Hotel, we're going to talk about quadrinopsias, hamonomous hemianopsias, bitemporal hemianopsias, et cetera. We'll get into that kind of detail clinically, as well as radiographically. But for now, let's focus on the MR, which shows an axial T2-weighted image through the optic nerve, a T1 image, non-contrast, and a sagittal, thin-section image right down the barrel of the optic nerve, which is right here. So this is not really that tricky a case. It's pretty straightforward that there is a problem with the optic nerve. Question is, what is wrong? What's the mass? And the mass on the T2-weighted image, which is this dark area, is almost uniformly hyper-intense, and you can see the optic nerve running right through the middle of it, kind of like a river runs through it. So the mass is making a track, or a tram track. You can see it on the T1-weighted image, a tram track of the mass around the gray optic nerve, which runs through it in the middle. And our mass trickles on back right to the orbital apex, which is not a good thing. Then in the sagittal projection, let's again look for the optic nerve. There it is running right through the center, and the mass is seen around the outside of it. Again, that tram track type of side, as opposed to a nerve that is exploded where you can't separate the nerve out from anything else. And this is typical of a meningioma of the optic nerve sheath. So the difference, if Simoninoma is thinking optic nerve glioma would be one, the nerve wouldn't be, you wouldn't have this tram track. Different patient demographic, right? Totally. I mean, optic. Neurofibromatosis, it would be an issue. NF1, you usually have gliomas between two and eight years of age. The average age, by the way, for optic meningiomas to present is 46. So this patient is almost at the perfect age. They're usually in women. This is a woman. They calcify more avidly and more frequently and more generously than would an optic nerve glioma, which doesn't calcify very often. Okay, now, most common intraconal lesion of hemangioma, right? Most common intraconal lesion. It should be bright on T2. This one's not. Nothing like this. Nothing like this. Even thrombost ones are not going to be black like this. They're not going to give you the tram track sign. And they would move the optic nerve out of the way. So let me put up a slightly motion-affected image. And you'll see just how vascular this is. Like all the rest of the meningiomas you've come to know and love, the entire area within the cone is enhancing because of this lesion and the hyperemia that it is creating. And when you get big meningiomas that grow back through the orbital apex and they can produce hydrocephalus, what can happen is, on one side, the optic disc is choked off and it gradually atrophies. And on the other side, if you get hydrocephalus, you get edema or papillodema of the optic disc. And this is known as- Foster Kennedy Syndrome. The Foster Kennedy Syndrome, a clinical little pearl for you. And hopefully you did know that. And hopefully you guys will hear about it when you visit us in New York at the Beacon Hotel on May 23rd.