Diagnosis: Demyelinating disease of central nervous system, unspecifiedClinical question: evaluate for demyelination The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a moderate degree of periventricular white matter lesions and subcortical white matter lesions. Many of the periventricular lesions are perpendicularly oriented to the lateral ventricles. These are stable when compared to the previous exam. No abnormal enhancing lesions are appreciated within the brain parenchyma. There is also lesion redemonstrated in the right middle cerebellar peduncle.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 demonstrate distorted shape of a small size. There is a fluid fluid level in the right eye. The patient is status post ocular surgery.
1.There is a moderate degree of periventricular white matter lesions and subcortical white matter lesions as well as a right cerebellar lesion all of which were present on the prior exam and have not changed. There is no convincing evidence for acute plaque formation.2.The eyes are distorted in appearance and a small. Please correlate with clinical history.