Nystagmus. There are multiple, greater than 10, T2 hyperintense lesions in the bilateral cerebral white matter, predominantly in a periventricular distribution. Many of the lesions also display T1 hypointensity. There are also T2 hyperintense lesions in the middle cerebellar peduncles and cerebellar white matter. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
The supratentorial and infratentorial white matter lesions are suggestive of a demyelinating disease, such as multiple sclerosis.