History of multiple sclerosis with slurred speech and weakness. Also recent sore throat with fevers. There are numerous, greater than 10, T2 hyperintense lesions involving the cerebral white matter, predominantly in a periventricular distribution. There are also T2 hyperintense lesion in the pons and bilateral middle cerebral peduncles. Many of the lesions are also T1 hypointense, but there is no associated enhancement. There may also be a T2 hyperintense lesion in the imaged upper cervical spine. There are nonspecific areas of susceptibility effect in the bilateral basal ganglia. However, there is no evidence of intracranial hemorrhage, mass, or acute infarct. The ventricles and sulci are diffusely prominent due to mild cerebral volume loss. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, mastoid air cells, paranasal sinuses, and scalp soft tissues are grossly unremarkable. There is diffuse thickening of the calvarium.There is mild prominence of the adenoids and there is a small amount of secretions in the nasopharynx.
1. Stigmata of multiple sclerosis, but no evidence of acute intracranial hemorrhage, abscess, or acute infarct. 2. Mild prominence of the adenoids and there is a small amount of secretions in the nasopharynx may be attributable to an upper respiratory tract infection.