 BRAIN: There are numerous (greater than 20) T2 hyperintense white matter lesions involving the midbrain, pons, medulla, bilateral middle cerebellar peduncles, periventricular and subcortical white matter, and the corpus callosum. Many of these lesions demonstrate a morphology and distribution characteristic of known demyelinating disease. There is diffuse global volume loss with involvement of the corpus callosum as well. Post contrast imaging was not obtained to assess for active demyelination. There is no acute infarct, mass effect, or cerebral edema. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The skull and extracranial soft tissues are unremarkable. CERVICAL: There are numerous T2 hyperintense lesions in the cervical spinal cord and medulla, most of which are long segment and confluent. There is extensive involvement from C2 -- C4-5 level, which is somewhat patchy extending inferiorly.The cervical spine is in normal alignment, with a normal cervical lordosis. The vertebral body and disk heights are well-maintained. No worrisome focal marrow signal abnormality is appreciated.At C2-C3, there is no spinal canal or neural foraminal stenosis.At C3-C4, there is no spinal canal or neural foraminal stenosis.At C4-C5, there is small right paracentral disk osteophyte complex with effacement of the right ventral thecal sac. No high grade spinal canal stenosis. No significant neural foraminal stenosis.At C5-C6, there is a central and right paracentral disk extrusion extending inferiorly with effacement of the right ventral thecal sac. No high grade spinal canal stenosis. No significant neural foraminal stenosis.At C6-C7, there is no spinal canal or neural foraminal stenosis.At C7-T1, there is no spinal canal or neural foraminal stenosis.THORACIC: There are T2 hyperintense lesions involving the thoracic cord at T1-3, T4- T5, T6-7 and T9 levels.The thoracic spine is in normal alignment, with a normal thoracic kyphosis. The vertebral body and disk heights are well-maintained. No worrisome focal marrow signal abnormality is appreciated. There is no significant spinal canal or neural foraminal stenosis.
1.Numerous white matter lesions involving the supratentorial and infratentorial brain, cervical, and thoracic cord. Findings are consistent with advanced demyelinating disease. No contrast was administered to assess for active demyelination. No priors are available for comparison, and addendum can be issued if prior studies are made available.2. Mild C4-5 and C5-6 degenerative changes without mild spinal canal narrowing. 