 Brain:There is no evidence of intracranial hemorrhage, mass, or acute infarct. Multiple lesions which demonstrate increased T2 signal are again present within the periventricular and to a lesser degree subcortical and juxtacortical white matter and appear unchanged. Several of these lesions are again perpendicularly oriented to the lateral ventricles. Several of the lesions also demonstrate associated decreased T1 signal appearing unchanged. There is a single punctate focus of increased T2/FLAIR signal within the lower left paramedian pons (series 901, image 15) which was not clearly visualized on the prior examination. 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. The previously seen mucosal thickening within the maxillary sinuses has improved. The midline structures and craniocervical junction are within normal limits.Cervical Spine: Postsurgical changes are present from anterior spinal fusion from C5-C7. There is mild straightening of the cervical spine. The vertebral body and disk heights are well-maintained. No worrisome focal marrow signal abnormality is appreciated. There are several foci of increased T2 signal within the cord which appear unchanged compared to the prior exam: along the left hemicord at the cervicomedullary junction, along the posterior lateral aspect of the left hemicord at the C2 level with associated trace volume loss, within the left hemicord at the C4-5 level, and within the lateral aspect of the spinal cord at C7-T1. No new cord signal abnormalities are identified. C2-C3: No significant central or foraminal stenosis.C3-C4: No significant central or foraminal stenosis.C4-C5: Mild central disc protrusion. No significant central canal stenosis. Mild right foraminal stenosis.C5-C6: Mild left lateral recess disc protrusion. No significant central canal or foraminal stenosis.C6-C7: No significant central or foraminal stenosis.C7-T1: No significant central or foraminal stenosis.
1.Multiple lesions throughout the brain compatible with history of demyelinating disorder. There is a single punctate focus of abnormal signal within the left paramedian pons which was not clearly visualized on the prior exam which could represent a new lesion or simply may be better seen on today's exam due to differences in technique. Otherwise, no new brain lesions or significant interval change.2.Stable cervical spinal cord lesions compatible with demyelinating disorder.