48 years Female (DOB: 8/20/1968)Reason: Multiple Sclerosis History: Follow up progressionPROVIDER NAME: ADIL JAVED ADIL JAVED MRI brain:There are multiple periventricular and subcortical T2 and FLAIR hyperintense patchy and partially confluent lesions scattered in both hemispheres of the cerebrum. Some of these extend towards the corpus callosum.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses demonstrate mucosal thickening. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.MRI cervical spine:The cervical vertebral bodies are appropriate in overall alignment and height. There are T2 hyperintense lesions present within the cervical spinal cord. One small one is located along the left posterior lateral aspect of the cervical spinal cord at the T2 vertebral level. Another one is present at the C4 vertebral body level along the right anterior aspect of the cervical spinal cord. Another one is present at the left hemicord at the C4-5 disc space level another one at the left posterior lateral aspect of the spinal cord at the C5-6 level. Still another one is present in the right hemicord at the C6-7 level.At C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there is no significant compromise to the spinal canal or neural foramina.At C4-5 there is no significant compromise to the spinal canal or neural foramina. There is small right lateral recess disc protrusion present this level which narrows the right neural foramen.At C5-6 there is no significant compromise to the spinal canal. There is a left lateral recess broad-based disc protrusion at this level which encroaches on the left-sided exiting nerve root within the neural foramen.At C6-7 there is no significant compromise to the spinal canal. There is a broad-based left lateral recess disc protrusion at this level which displaces the left hemicord and encroaches on the left-sided exiting nerve root.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact.Thoracic spine:There is a T2 hyperintense lesion present within the thoracic spinal cord at the T2 level, there is the right hemicord at the T4 vertebral level and another one in the right hemicord at the T5 level, another in the right hemicord at the T7 and T8 levels, one in the right anterolateral aspect of spinal cord at the T9 level and still another one at the conus at the T12 level.The thoracic vertebral bodies are appropriate in the overall alignment and height. The thoracic spinal cord has normal signal characteristics and overall morphology. There is no compromise of thoracic spinal canal or exiting nerve roots. There is a central disc protrusion present at T3-4 which effaces spinal fluid ventral but not posterior the spinal cord.
1.There are multiple patchy lesions in the periventricular white matter which are nonspecific but compatible with patient's diagnosis of demyelinating disorder.2.There are multiple lesions present within the cervical spinal cord and thoracic spinal cord compatible with demyelination.3.There are degenerative changes present cervical spine worse at C5-6 and C6-7 there is encroachment of the left-sided exiting nerve roots at C5-6 and C6-7 as well as the left hemicord at C6-7.4.There are degenerative changes present in the thoracic spine with a central disc protrusion at T3-4.