History of multiple sclerosis, history of radiotherapy to trigeminal with residual edema. Multifocal variable sized bihemispheric, supra and infra tentorial high signal foci indicating multiple sclerosis lesions do not show any significant interval change in terms of lesion number is and signal intensity on FLAIR imaging since prior scan.Localized enhancing lesion on the right hippocampus appears to be slightly smaller in terms of enhancement extent but the extent of surrounding edema does not show any significant interval change since prior scan.Diffuse enhancement of cistern segment of the right trigeminal nerve does not show significant interval change since prior scan.High signal intensities on FLAIR images on the right middle cerebellar peduncle and lateral aspect of lower pons do not show any interval change either.The ventricles, sulci and cisterns are symmetric and unremarkable. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.
1. No interval change of 1) multiple FLAIR high signal intensity lesions indicating MS lesions, 2) focal enhancing lesion on the right hippocampus as well as right trigeminal nerve and 3) right middle cerebellar peduncle and right side of lower pons since prior exam.2. No evidence of new ischemic or hemorrhagic lesion. No evidence of new abnormal enhancement.