Unspecified infectious and parasitic diseases. Infectious acute disseminated Clinical question: compare to prior ADEM vs. MS evaluate for new lesionsSigns and Symptoms: R facial paresthesias The CSF spaces are appropriate for the patient's stated age with no midline shift. Several punctate subcortical and periventricular white matter lesions present in the right hemisphere - one in the right parietal lobe subcortical white matter and another in the right centrum semiovale - which are hyperintense on T2 and FLAIR images are redemonstrated and have not changed.There is a T2 and FLAIR hyperintense irregularly shaped lesion centered in the right middle cerebellar peduncle which was more evident on the prior exam than on the current exam. It measures approximately 8 x 11 mm axial dimensions on the current exam and slightly larger dimensions on the prior exam. There is no associated diffusion restriction and no associated susceptibility effect appreciated. This low signal on T1-weighted imaging and does not display any contrast enhancement.No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.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.The right cerebellar peduncle lesion is present which is somewhat less conspicuous on the current exam. It is possible that this is sequela of ADEM but it is nonspecific.2.A couple subcortical and periventricular white matter lesions present in the right parietal lobe and right centrum semiovale which are nonspecific and stable.