Female, 41 years old, with headaches and visual changes. Numerous scattered foci of periventricular and juxtacortical T2 hyperintensity are again seen. Some of these lesions are oriented relatively perpendicular to the ventricular surface. Accounting for significant differences in technique on the prior comparison examination, no definite change in the size or number of lesions is seen. However, new enhancement is seen corresponding to a lesion along the left ventricular atrium. Some of the above-mentioned lesions are associated with mild to moderate T1 hypointensity.No significant parenchymal edema or mass effect is detected. No intracranial hemorrhage or any abnormal extra-axial fluid collection is suspected. Brain parenchymal volume is preserved. The ventricular system is normal in size and morphology.
Numerous scattered white matter lesions are redemonstrated showing no significant interval change in size or number when compared to the prior examination. However, a lesion along the left ventricular atrium does appear to be newly enhancing. As before, these lesions would be compatible with a demyelinating process, with additional considerations including sequelae of migraine or vasculitis.