19 year-old female with slurred speech, evaluate for stroke and demyelination There are numerous foci of T2/FLAIR hyperintensity within both periventricular and subcortical white matter locations involving the supratentorial brain bilaterally as well as corpus callosum proper, the right cerebral peduncle, and perhaps the right anterior medulla. These foci also demonstrate slight restricted diffusion with ADC which appears mildly hypointense with a few lesions also demonstrating mixture with ADC hyperintense signal. A few of the larger lesions demonstrate T1 hypointensity. Some of these lesions are new, and others have significantly enlarged compared to prior. A previous corpus callosal genu lesion has decreased.The CSF spaces are appropriate for the patient's stated age with no midline shift. No intracranial hemorrhage is identified. Normal vascular flow voids are present. The visualized portions of the paranasal sinuses and mastoid air cells are clear. The visualized portions of the orbits are intact.
There are numerous foci of T2/FLAIR hyperintensity within both periventricular and subcortical white matter locations involving the supratentorial brain bilaterally as well as corpus callosum proper, the right cerebral peduncle, and perhaps the right anterior medulla. These foci also demonstrate slight restricted diffusion with ADC which appears mildly hypointense with a few lesions also demonstrating mixture with ADC hyperintense signal. A few of the larger lesions demonstrate T1 hypointensity. Some of these lesions are new, and others have significantly enlarged compared to prior. A previous corpus callosal genu lesion has decreased. These findings are nonspecific, however would be consistent with demyelination in the appropriate clinical context. Other inflammatory etiologies remain within the differential diagnosis. Given the distribution and lack of defined vascular territorial involvement, ischemia is unlikely.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.