Multiple sclerosis treated with Tysabri. Brain: There are a few scattered subcortical supratentorial T2 hyperintense white matter lesions. There are also T2 hyperintense lesions in the anterior medulla, left cerebellar hemisphere white matter, and at the junction between the right lateral pons and the middle cerebellar peduncle. 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 orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.Spine: There are multiple T2 hyperintense lesions within the cervical and thoracic spinal cord, as well as in the conus medullaris region, generally measuring approximately 1 to 2 cm in length. The vertebral column alignment is within normal limits. There is irregularity of the T12 superior endplate associated with a limbus vertebra. The vertebral body and disc space heights are otherwise preserved. The vertebral bone marrow signal is unremarkable. There is a disc-osteophyte complex and bilateral facet hypertrophy at C5-6 that results in mild spinal canal stenosis and moderate-to-severe bilateral neural foramen stenosis. There are also disc-osteophytes at T7-8 and T8-9 that mildly indent the spinal cord, but do not results in neural foraminal stenosis. The paravertebral soft tissues are unremarkable.
1. Several intracranial and spinal cord lesions may represent demyelinating process, but are incompletely characterized without contrast.2. A disc-osteophyte complex and bilateral facet hypertrophy at C5-6 results in mild spinal canal stenosis and moderate-to-severe bilateral neural foramen stenosis. 3. Disc-osteophytes at T7-8 and T8-9 mildly indent the spinal cord. 