Reason: please do Dr Javed MS protocol on 3 tesla and compare to prior History: numbness and fatigue. MRI brain:The CSF spaces are appropriate for the patient's stated age with no midline shift. There is redemonstration of multiple punctate subcortical and periventricular white matter lesions which are bright on T2 and flair MRI.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 demonstrate some mucosal thickening in the maxillary sinuses and opacities scattered in the maxillary sinuses and ethmoid air cells.. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.MRI cervical spine:The cervical vertebral bodies are appropriate in overall alignment and height. The cervical spinal cord has normal signal characteristics and overall morphology. No abnormal enhancing lesions are identified in the cervical spine.At C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there is no significant compromise to the spinal canal or neural foramina.At C4-5 there is no significant compromise to the spinal canal or neural foramina.At C5-6 there is no significant compromise to the spinal canal or neural foramina. There is a small central disk protrusion present at this level. This is stable when compared to the prior exam.At C6-7 there is no significant compromise to the spinal canal or neural foramina.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact.
1.There is re-demonstration and no change in the number or extent of the patient's white matter lesions in the brain.2.No convincing evidence for cervical spinal cord involvement at this time.3.A small central disk protrusion is present at C5-6 without any significant compromise to the spinal canal or exiting nerve roots.