 MRI brain: There is redemonstration of extensive linear and rounded foci of T2/FLAIR signal abnormality in the periventricular and to a lesser degree the subcortical white matter of the bilateral cerebral hemispheres. There is also an unchanged lesion in the dorsal aspect of the corpus callosum. There are patchy lesions also within bilateral thalami, pons, right middle cerebellar peduncle and minimally of the left cerebellar hemisphere. The lesion in the right aspect of the pons is more conspicuous compared to prior study and may be new. There is unchanged mild prominence of the sulci, greater than expected for patient age, which is consistent with underlying parenchymal volume loss. The ventricles are within normal limits. The basal cisterns remain patent. There is no midline shift or mass effect. There are no areas of abnormal signal. There is no diffusion abnormality. No extra-axial fluid collection is identified. There is a small mucous retention cyst in the right maxillary sinus.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. MRI cervical spine: There is mild reversal of the normal cervical lordosis. The vertebral body heights are well-maintained. There is moderate loss of disc height at C-4-5, C5-6 and C6-7. No worrisome focal marrow signal abnormality is appreciated. There is diffuse, patchy increased T2/STIR signal throughout the cervical cord, most prominent at the right dorsal aspect of the cervicomedullary junction, the right dorsal aspect at the C2 level and right lateral aspect at the C4-5, C6-7, and C7-T1 levels. There is associated volume loss of the cervical cord at these levels, progressed from prior study. There are scattered cervical spondylotic changes, similar to prior study.
1. Findings compatible with known multiple sclerosis with a new right pontine lesion, but otherwise grossly stable intracranial lesion burden. 2. Diffuse, patchy increased T2/STIR signal throughout the cervical cord, likely unchanged in configuration, but interval progression of associated cord volume loss.