Evaluate for accumulation of MS lesions. There are numerous cerebral white matter lesions bilaterally, mainly in a periventricular distribution, but also in the right paracentral lobule subcortical white matter, as well as in the right cerebellar hemisphere. Some of the lesions demonstrate low signal on T1 weighted sequences, but there is no evidence of associated enhancement. There is no evidence of intracranial hemorrhage, mass, or acute infarct. The ventricles and basal cisterns are unchanged 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.
No appreciable change in the burden of demyelinating lesions related to multiple sclerosis and no evidence of acutely inflamed lesions.