Vision and weakness of right leg. Evaluate for multiple sclerosis burden of disease. There are multiple ovoid T2 hyperintense lesions within the cerebral white matter. Although some lesions are no longer identified, there is an overall increase in size and number of T2 hyperintense lesions, with several lesions diffusely enhancing, while other are peripherally enhancing. For example, a new ring-enhancing lesion within the right superior frontal gyrus measures 0.7 x 0.6 cm. There are multiple new T2 hypertense lesions within the corpus callosum, one of which demonstrates enhancement (series 701, image 19; series 1201, image 19). There also appears to be an enhancing lesion in the left optic nerve. There is also a new T2 hyperintense focus within the right cerebellum, which does not exhibit restricted diffusion or enhancement. There is no evidence of intracranial hemorrhage or acute infarction. There is an unchanged partially empty sella. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
Increased number of demyelinating lesions, many of which demonstrate enhancement.