Diagnosis: Demyelinating disease of central nervous system, unspecifiedClinical question: eval for demyelinating diseaseSigns and Symptoms: paresthesias MRI brain:The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images. These were also present on the prior exam.No abnormal 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 a small mucous retention cyst in the left maxillary sinus. 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. There is mild reversal of the normal cervical curvature present.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.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.Thoracic spine:The thoracic vertebral bodies are appropriate in the overall alignment and height. The thoracic spinal cord has normal signal characteristics and overall morphology. There is no compromise of thoracic spinal canal or exiting nerve roots.
1.Periventricular and subcortical white matter signal changes of a mild degree are present which are nonspecific. They're stable when compared to the prior exam. They could be vascular related, related to demyelination, trauma, vasculitis, sarcoid. They are nonspecific. 2.No abnormal lesions are identified in the spinal cord.3.There is no compromise of the cervical spinal canal or exiting nerve roots. No abnormal lesions are identified within the cervical spinal cord.4.There is no compromise of the thoracic spinal canal or exiting nerve roots. No abnormal lesions are identified within the cervical spinal cord.5.There is mild reversal of the normal cervical curvature present which could be related to patient positioning or muscle spasm.