MS flare versus new ischemia. There is redemonstration of multiple hyperintense T2/FLAIR foci in the periventricular region. Two large lesions are seen in the right peri-atrial white matter, which demonstrates progressive T1 hypointensity, suggestive of chronic evolution and tissue loss. A high T2 signal lesion is seen in the splenium and posterior aspect of the corpus callosal body. High T2 signal is also seen in the hypothalamus, left greater than right. Additional high T2 signal is seen in the left periventricular region of the temporal horn with tiny lesions in the right greater than left cerebellum. There are a few subcortical high signal lesions. There is high T2 right cerebellar peduncle. There is no evidence of intracranial hemorrhage, mass, or acute infarct. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The skull and extracranial soft tissues are unremarkable. There is interval progression of mucosal thickening of the visualized paranasal sinuses. There is a partially empty sella.
1. Multiple scattered white matter lesions without significant interval change. No enhancing lesion to suggest active demyelination.2. No evidence of acute intracranial hemorrhage, mass, or acute infarct.