Diagnosis: Multiple sclerosisClinical question: please do Dr Javed MS protocol compare to priorSigns and Symptoms: numbness The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a moderate degree of periventricular and subcortical white matter lesions present some of which are perpendicularly oriented to the lateral ventricles. Some extend to the calloso-cingulate junction and into the inferior aspect of the corpus callosum. Additional lesions are present in the brainstem, cerebellum and internal capsules. These lesions are hyperintense on FLAIR and T2 sequences and hypointense on T1 sequences. They are not associated with contrast enhancement.No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.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 are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
Multiple white matter lesions are present throughout the brain as detailed above which have been stable since the prior exam and consistent with the clinical history of demyelinating disorder. There is no MRI evidence for acute plaque formation.