31 years Male (DOB:8/8/1984)Reason: Please perform Dr Javed MS protocol (with DTI) History: PML due to idiopathic lymphopeniaPROVIDER/ATTENDING NAME: JACQUELINE T. BERNARD JACQUELINE T. BERNARD There is redemonstration of T2 signal hyperintensity involving the subcortical and periventricular white matter of the right occipital lobe and parietal lobe, the splenium of the corpus callosum and to lesser degree the subcortical and periventricular white matter of the left occipital lobe and left parietal lobe. Additionally there is T2 and FLAIR signal hyperintensity present along the posterior aspect of the left superior frontal gyrus and to lesser degree left middle frontal gyrus. When compared to the 6/11/2016 exam the extent of these signal hyperintensities has mildly progressed despite the short time interval especially when one looks at the left middle frontal gyrus and left superior frontal gyrus. On the right side there appears to be some extension into the posterior most aspect of the right paracentral lobule subcortical white matter which is relatively new. 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 demonstrate some scattered opacities in the ethmoid air cells. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.Since the prior exam of 6/11/2016 there appears to be some mild further extension of white matter disease into the left frontal lobe and right paracentral lobule. This compatible mild progression of the patient's clinical diagnosis of PML.