 BRAIN: There are numerous T2 hyperintense lesions within the supratentorial white matter. Some have resolved or decreased in size while others have increased in size or occurred in the interval since the prior exam; with the most prominent new lesion located in the deep right frontal white matter extending into the genu of the corpus callosum. Many of these new lesions enhance and many of the larger lesions have associated T1 hypointensity. There are no posterior fossa lesions identified. There is no evidence of acute intracranial hemorrhage, mass, or acute infarct. There are two unchanged punctate foci susceptibility effect within the right parietal lobe. 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 skull and scalp soft tissues are unremarkable. There is mild mucosal thickening within the left maxillary sinus.CERVICAL SPINE: There are several ill-defined T2 hyperintense lesions throughout the cervical spine without associated cord expansion. These appear grossly decreased in signal intensity and number while an enhancing lesion at the C3 level has resolved. There are however two new bilateral enhancing T2 hyperintense lesions at the C6 level. There is minimal unchanged myelomalacia at the level of C4. The vertebral column alignment is within normal limits. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is unremarkable. There is no significant spinal canal stenosis. The paravertebral soft tissues are unremarkable.
1.Numerous intracranial lesions isolated to the supratentorial compartment. Some have resolved or decreased in size, while some are new or have increased in size. 2.Numerous cervical spinal cord lesions. Some have resolved or decreased in size, while there are two new enhancing lesions at the C6 level. There is also unchanged mild myelomalacia at C4. 