72 years Female (DOB:9/17/1943)Reason: rule out structural lesion including MS History: gait problem, blurry vision, weaknessPROVIDER/ATTENDING NAME: GABRIELLA L BORRELLI GABRIELLA L BORRELLI The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a moderate degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images. Additional punctate T2 and FLAIR hyperintense foci are present in the brainstem. There are enlarged perivascular spaces in the basal ganglia.There is a punctate focus of signal loss in the right centrum semiovale on susceptibility weighted imaging. In isolation this is of microhemorrhages are known clinical significance.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus. The right vertebral artery flow-void is very small.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
Periventricular and subcortical white matter lesions of a moderate degree and a few punctate lesions in the brainstem are nonspecific. At this age they are most likely vascular related. Although not particularly characteristic of demyelination based on the morphology and pattern of demyelination cannot be excluded based on this exam. These lesions are nonspecific and demyelinating disorder is in the differential diagnosis..