Reason: MS; f/u progression History: paresthesias MRI brain:The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a mild degree of periventricular and right cerebellar punctate hyperintense white matter lesions present identified on the FLAIR and T2 images. When compared to the prior exam these have not changed compared there is no associated contrast enhancement.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The right maxillary sinus is very small compared to the left suggesting atelectasis of the right maxillary sinus. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.Thoracic spine:The thoracic vertebral bodies are appropriate in the overall alignment and height. The thoracic spinal cord has normal signal characteristics and overall morphology. There is no compromise of thoracic spinal canal or exiting nerve roots.
1.Redemonstration and no change of peri-ventricular white matter lesions and a right cerebellar lesion which are stable when compared to the prior exam and compatible patients known clinical history of demyelination2.no convincing evidence for thoracic spinal cord involvement of a demyelination.