 There is redemonstration of numerous foci of T2/FLAIR hyperintensity within the supratentorial and infratentorial brain, including the brainstem. There is a large new lesion in involving the white matter adjacent to the posterior horn of the left lateral ventricle in the left parietal lobe measuring 2.0 x 1.7 cm. This lesion demonstrates discontinuous peripheral postcontrast enhancement. The previously identified lesion adjacent to the frontal horn of the left lateral ventricle appears decreased in size measuring 1.0 x 0.6 cm, previously 1.6 x 1.1 cm. A punctate lesion in the left middle cerebellar peduncle appears similar to prior examination. Numerous additional smaller lesions appear similar to prior examination, many with corresponding T1 hypointensity. The lesion identified in the right anterior medulla also appears similar to prior examination. No midline shift is appreciated. The basal cisterns are patent. No intra-axial or extra-axial fluid collections are visualized.
1. There is a new 2.0 cm T2 hyperintense white matter lesion involving the left parietal lobe with discontinuous peripheral enhancement consistent with active demyelination.2. The previously identified white matter lesion adjacent to the frontal horn of the left lateral ventricle appears decreased in size from prior examination consistent with expected evolution.3. Accounting for differences in technique, numerous additional foci of T2/FLAIR hyperintensity involving the supratentorial and infratentorial white matter appear grossly similar to prior examination and do not demonstrate postcontrast enhancement.