62-year-old man with history of left lower extremity weakness, evaluate for demyelinating lesion. There are bilateral periventricular and subcortical foci of T2/FLAIR hyperintensity in the white matter arranged radially similar to the prior examination. This includes areas of signal abnormality in the subcortical right parahippocampal gyrus and right hand motor area. Additionally, there are a few prominent perivascular spaces of CSF signal along the basal ganglia and internal capsule. There are no foci of abnormal enhancement. A small development venous anomaly is incidentally noted in the left frontal lobe.The ventricles and sulci are normal in size and configuration. The major flow-voids are preserved. There is abnormal signal in the posterior right globe, unchanged and likely related to prior subchoroidal hemorrhage. The paranasal sinuses and mastoid cells are clear. There is a lipoma in the right frontal scalp, otherwise the marrow signal and extracranial soft tissues are within normal limits. CERVICAL SPINE
1.Multiple T2 hyperintense lesions in the brain and spinal cord with a morphology suggestive of demyelinating disease. However, no enhancing lesions are identified.2.Osseous and soft tissues of the spine are essentially unremarkable with minimal degenerative changes.3.Trace pleural fluid, left perihilar bronchiectasis, and interstitial thickening partially imaged but possibly related to edema.