 BRAIN: There are unchanged numerous T2 hyperintense lesions mainly centered within the corpus callosum and periventricular white matter as well as a few additional unchanged lesions within the cerebellar white matter and middle cerebellar peduncles. There is no evidence of intracranial hemorrhage, mass, or acute infarct. 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 skull, paranasal sinuses, and scalp soft tissues are unremarkable. CERVICAL SPINE: There are unchanged T2 hyperintense lesions located at the cervicomedullary junction, as well as at the C4 and at C6-T1 where there is unchanged mild myelomalacia. There is ill-defined enhancement at the C7 level that was not definitely present on the prior exam. There is a minimal unchanged disc osteophyte complex at C5-C6. The vertebral column alignment is within normal limits. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is unremarkable. There is no significant spinal canal stenosis. The paravertebral soft tissues are unremarkable.
1.There is no significant change in the supratentorial and infratentorial multiple sclerosis lesion burden.2.There is minimal enhancement of a lesion centered at the C7 level that was not definitely present on the prior exam. There is otherwise no significant change in the cervical spinal cord lesions or the myelomalacia centered at C7.