Clinical question: MS, new L weakness, falls. Signs and Symptoms: L weakness, falls Unenhanced brain MRI:Negative diffusion weighted series.Examination demonstrate minimal findings of demyelinating disease with suggestion of subtle interval progression since prior MRI exam from 7 -- 1 -- 2013.The new small new lesions are identified in the subcortical white matter of left temporal and flair T2 series 8 image 16, left superior cerebellar peduncle on flair series 8 image 19 and a tiny lesion in the anterior medulla on flair series 8 image 22. Note should be made that this examination is performed without intravenous contrast.Previously noted focus of flair hyperintensity in the lower medulla is again identified on flair/T2 series and without convincing evidence of any change in size. This finding also is not associated with any change in the caliber of the medulla. There is slight generalized prominence of the cerebral cortical sulci for patient's stated age of 39 which appears more pronounced compared to prior exam however this observation may be secondary to better quality current exam.Signal void of major intracranial arterial branches are identified.Unremarkable images through the orbits, paranasal sinuses and mastoid air cells.
White matter foci of flair hyperintensity consistent with mild demyelinating disease with evidence of few tiny new lesions since prior study as detailed.