47 years Female (DOB:5/20/1968)Reason: please do dr Javed MS protocol and compare to prior History: progression MSPROVIDER/ATTENDING NAME: JACQUELINE T BERNARD JACQUELINE T BERNARD The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a mild degree of periventricular white matter lesions present some which are perpendicularly oriented to the lateral ventricles. Additionally there are some subcortical white matter lesions present as well. These lesions are hyperintense on T2 and FLAIR MRI . There is a T2 and FLAIR hyperintense lesion present in the right precentral gyrus which is not readily appreciated on the prior exam.There is redemonstration of a T2 and FLAIR hyperintense lesion within the anterior aspect of the medulla on the left and another one along the left cerebral peduncle.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.MRI cervical spine:The cervical vertebral bodies are appropriate in overall alignment and height. There is redemonstration of multiple patchy T2 hyperintense lesions within the cervical spinal cord. There are unchanged compared to the prior exam. No abnormal enhancing lesions are identified in the cervical spine.At C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there is no significant compromise to the spinal canal or neural foramina.At C4-5 there is no significant compromise to the spinal canal or neural foramina. There is a mild disc bulge present this levelAt C5-6 there is no significant compromise to the spinal canal or neural foramina. There is a disc bulge associated with endplate and bilateral uncovertebral osteophytes at this level.At C6-7 there is no significant compromise to the spinal canal or neural foramina. Some loss of disc space height this desiccation and endplate reactive changes associated with a disc bulge, endplate osteophytes and uncovertebral osteophytes at this level.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact.
1.There is redemonstration of multiple white matter lesions in the subcortical and periventricular white matter as well as in the brainstem. When compared to the previous exam most lesions are stable. There appears to be a new lesion in the right precentral gyrus. Lack of contrast enhancement generally implies nonacute plaque formation. These are compatible with patient's diagnosis of multiple sclerosis.2.There is redemonstration of significant change of multiple lesions throughout the cervical spinal cord. These are compatible with patient's diagnosis of multiple sclerosis.3.There are degenerative changes present in the cervical spine without significant compromise to the spinal canal or exiting nerve roots. Worst levels appear to be C5-6 and C6-7.