 MRI Brain: There are no areas of abnormal signal or pathological enhancement to suggest demyelinating disease. There is a normal variant cavum septum pellucidum and vergae. The ventricles and sulci are within normal limits. The cisterns remain patent. There is no midline shift or mass effect. There is no diffusion abnormality. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. There is a small left maxillary sinus mucosal retention cyst, with other scattered mild thickening in the paranasal sinuses.MRI Orbits: Images are limited by patient motion, especially axial STIR images. There is diffuse atrophy of the optic nerves bilaterally, with again questioned mild increased T2 signal. There is no definite associated enhancement. The optic chiasm is not well delineated secondary to its significant atrophy.The globes and extraocular muscles are otherwise unremarkable.
1. Redemonstration of optic apparatus atrophy with likely chronic signal changes, without definite focal enhancement.2. Unremarkable contrast enhanced MRI of the brain.