72 years Female (DOB:10/23/1943)Reason: progression of WM lesions? History: gait decline history of multiple sclerosisPROVIDER/ATTENDING NAME: JAMES R. BRORSON JAMES R. BRORSON There is a moderate to marked degree of periventricular and subcortical T2 and FLAIR signal intensity lesions which were also present on the prior exam from 2012. Comparing the 2 exams a not changed substantially.There are punctate foci of T2 and FLAIR signal hyperintensity in the basal ganglia, thalami and brainstem which were also present on the prior exam and do not appear to have progressed significantly when compared.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.
1.There are multiple lesions in the brainstem and basal ganglia and thalami which are stable. Given the patient's clinical history of multiple sclerosis these could very well represent prior demyelinating plaques. Please note that the lacunar infarcts may have a similar appearance.2.There is a moderate to marked degree of periventricular and subcortical white matter lesions which were also present on the prior exam and have not changed significantly. Given patient's clinical history much of this may represent demyelination, however, vascular related lesions can have a similar appearance.3.There is no evidence for acute cerebral ischemic infarction.4.Examination is mildly degraded due to motion artifact which may obscure more subtle abnormalities.