migraine, intermittent right arm pain. No evidence of acute ischemic or hemorrhagic lesion.There are multifocal scattered somewhat confluent high signal lesions on bilateral hemispheres on FLAIR images. In particular, those lesions are located on right centrum semiovale, bilateral periventricular white matter, right trigone area, right middle cerebellar peduncle and bilateral frontal lobes. Signal intensities of most of lesions appear to be lessen since prior exam, however, current examination has been performed in different magnetic strength, thus cannot be comparable.Previously suggested subtle enhancement on optic apparatus around optic chiasm is not appreciable on today's scan. There is no abnormal enhancement on this scan. The ventricles, sulci and cisterns are symmetric and unremarkable.There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, or restricted diffusion/acute ischemia. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.
Multifocal high signal foci on bilateral hemispheres and posterior fossa on FLAIR indicating possible demyelinating disease such as MS, no change of lesions' distribution and size since prior exam.