Multiple sclerosis follow up. Brain: There are multiple unchanged cerebral white matter T2 hyperintense lesions, primarily in a periventricular distribution, but also in juxtacortical locations, such as in the right occipital lobe. There is no associated enhancement and there is no evidence of intratentorial lesions. The ventricles and sulci are normal is size and configuration. There is no evidence of intracranial mass lesions. There is no midline shift or herniation. The major cerebral flow voids are grossly intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.Spine: There is now a subcentimeter T2 hyperintense and enhancing lesion in the right lateral spinal cord at the C4-5 level. The rest of the cervical and thoracic spinal cord appears unremarkable. The vertebral column alignment is within normal limits. There are intravertebral disc herniations in the T10 and T11 vertebral bodies. The vertebral body and disc space heights are otherwise preserved. There is a hemangioma in the T9 vertebral body that measures up to 15 mm. There is no significant spinal canal stenosis. The paravertebral soft tissues are unremarkable.
1. No significant interval change in the cerebral demyelinating lesions.2. An enhancing demyelinating lesion in the right lateral spinal cord at the C4-5 level is new from 2014. 