Reason: ms evaluate for progression History: R trigeminal neuralgia and R sided weakness MRI brain:The CSF spaces are appropriate for the patient's stated age with no midline shift. There is redemonstration of multiple periventricular and subcortical white matter lesions which are hyperintense on T2 and flair MRINo 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.MRI cervical spine:The cervical vertebral bodies are appropriate in overall alignment and height. There is redemonstration of T2 signal hyperintense lesions within the cervical spinal cord without any significant mass-effect. One is located along the right posterolateral spinal cord at the C2-3 level another is located along the right lateral spinal cord at the C3-4 level and other ones are located in the lower cervical cord. These can also be identified on the prior exam. 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. There is a disk bulge at this level.At C4-5 there is no significant compromise to the spinal canal or neural foramina. There is loss of disk space height associated with a disk bulge and endplate and uncovertebral osteophytes. There is partial effacement of the spinal fluid surrounding the cervical spinal cord at this level when compared to the prior exam.At C5-6 there is no significant compromise to the spinal canal. There is some narrowing of the neural foramina present at the C5-6 level left more than right due to uncovertebral osteophytes and disk materialAt C6-7 there is no significant compromise to the spinal canal or neural foramina. There are endplate and uncovertebral osteophytes present at this levelAt C7-T1 there is no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact.Postcontrast examination is somewhat compromised by patient motion.
1.There is redemonstration of numerous periventricular and subcortical white matter lesions which are stable compared to the prior exam.2.There is redemonstration of multiple cervical spinal cord lesions which are also stable when compared to the prior exam.3.Some imaging is degraded due to motion artifact4.There are degenerative changes present in the cervical spine, worse at C4-5, where there is a mild degree of spinal stenosis and some neural foraminal encroachment of exiting nerve roots.