Reason: evaluate for disease activity History: dizziness and worsening visual acuity; h/o multiple sclerosis 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. One of the lesions is in the right calloso-cingulate junction. Another lesion is present along splenium of the corpus callosum on the left side and is new compared to the prior exam. Previously enhancing lesion in the corpus callosum posteriorly within the body no longer enhances.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 are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.MRI orbits:The eyeballs are intact. No intraconal or extraconal space mass is identified. The extraocular muscles are intact. The lacrimal glands are symmetric and within normal limits in size and configuration. There is no optic nerve enhancement appreciated. The suprasellar cistern is intact .
1.Periventricular and subcortical white matter signal changes of a mild degree are present which are nonspecific. They could be vascular related, related to demyelination, trauma, vasculitis, sarcoid. They are nonspecific. There is a new lesion present along the splenium of the corpus callosum which was not clearly present on the prior exams.ptic neu2.There's evidence for optic nerve enhancement to suggest optic neuritis.