Female, 35 years old, with fatigue, gait disorder, and previous abnormal MRI. Redemonstrated are numerous small foci of T2 hyperintensity and T1 hypointensity, ranging in size from punctate up to about 5 mm, identified within the bilateral deep and subcortical cerebral white matter. There is also a larger curvilinear focus of T2 hyperintensity involving the cortex and subcortical white matter of the right frontal operculum. Of note, no lesions are seen within the corpus callosum and there are no infratentorial lesions. These lesions are unchanged and there are no definite new lesions. Postcontrast images demonstrate no evidence of pathologic parenchymal or extra-axial enhancement. Brain morphology is otherwise unremarkable. No mass-effect or parenchymal edema is detected. No abnormal fluid collections are seen. The ventricles are normal in size and morphology.
Stable appearing scattered small foci of signal abnormality are identified in the bilateral cerebral white matter with one larger lesion also involving the cortex of the right frontal operculum. None of the lesions demonstrates contrast enhancement. The corpus callosum and posterior fossa are spared. There are no definite new lesions.