Diagnosis: Multiple sclerosis. Transient alteration of awarenessClinical question: Assess status of MS, identify possible lesions that may have caused seizures or confusion in generalSigns and Symptoms: History of MS, acute confusional state The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a moderate degree of periventricular and subcortical white matter T2 and FLAIR hyperintense lesions present some of which are perpendicularly oriented to the lateral ventricles. Additional lesions are present in the brainstem and cerebellar hemispheresNo abnormal enhancing 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 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.There is a cystic lesion just beneath the floor of the left maxillary sinus which this forms the floor of the left maxillary sinus and is associated with patient's dentition.
1.There are multiple lesions scattered in both hemispheres of the brain as well as the brainstem and cerebellum which are compatible patient's clinical diagnosis of demyelinating disorder. No enhancing lesions are appreciated to suggest acute demyelination.2.Findings are suggestive of a radicular cyst involving the left maxillary dentition.