History of slurred speech, pain in the right shoulder and multiple sclerosis. Reason for study: Stroke or other acute findings. This is a slightly motion degraded exam. There is redemonstration of multiple supratentorial periventricular and subcortical white matter lesions, as well as lesions in the brainstem and cerebellar hemispheres not significantly changed in the interval. Extent of the white matter lesions and motion degradation makes evaluation difficult, however, no new lesion is appreciated. Many of the lesions demonstrates T1 hypointensity. No enhancing lesions are seen within the brain parenchyma. There is no evidence of intracranial hemorrhage, mass, or acute infarct.Partial visualization of the cervical cord again demonstrates T2 hyperintensity in the right aspect of the cord, which was present previously (7/10/2014, not included on most recent study). There is ,however, a smaller T2 hyperintense lesion in the dorsolateral spinal cord at the C1 level which appears new and demonstrates enhancement compatible with active demyelination. The pituitary gland appear unremarkable. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
1. Redemonstration of multiple supratentorial and infratentorial lesions compatible with demyelinating disease. No significant interval change in lesions in the brain parenchyma.2. New enhancing focus in the dorsolateral cervical cord at the C1 level compatible with active demyelination.