NMO: weakness in legs. Brain: There is no evidence of intracranial hemorrhage, mass, or acute infarct. There are a few punctate foci of white matter T2 hyperintensity in the bilateral frontal lobes. There is no abnormal intracranial enhancement. 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 skull and scalp soft tissues are grossly unremarkable. There is mild scattered paranasal sinus mucosal thickening.Orbits: There is diffuse volume loss of the left orbital segment of the left optic nerve with associated high T2 signal. The right optic nerve appears to be unremarkable. The globes, extraocular muscles, lacrimal glands, and orbital fat also appear to be intact bilaterally. There is no evidence of intraorbital mass lesions.Spine: There has been marked interval decrease in the degree of upper spinal cord edema with residual patchy high T2 signal and enhancement measuring up to 35 mm in length at the C2-3 to C4-5 levels. The thoracic spinal cord is unremarkable. The vertebral column alignment is within normal limits. The vertebral body and disc space heights are preserved. There is a hemangioma in the T5 vertebral body. The vertebral bone marrow signal is otherwise unremarkable. There is no significant spinal canal stenosis. The paravertebral soft tissues are unremarkable. However, there are multiple thyroid nodules, the largest of which measures up to approximately 15 mm.
1. Marked interval decrease in the degree of upper spinal cord edema patchy high T2 signal and enhancement measuring up to 35 mm in length at the C2-3 to C4-5 levels, which may be a manifestation of NMO. 2. Left optic nerve atrophy, which may a chronic sequela of NMO involvement.3. Nonspecific bilateral punctate frontal lobe white matter lesions. 4. Multiple nonspecific thyroid nodules.