29 years, Female, blurred vision, paresthesias. Follow-up progression. Demyelinating disease. Per medical record, patient has history of respiratory infection following which patient developed multiple lesions within the spinal cord, brain, and orbits. Brain: Examination is limited to sequences per demyelinating disease protocol. No lesions within the brain to suggest chronic demyelinating disease are appreciated. Previously seen signal abnormality involving the left pons and middle cerebellar peduncle appears to have resolved. Brain parenchymal volume is maintained. No evidence of intracranial mass or mass effect. No midline shift or herniation. No hydrocephalus. No extra-axial collections. Calvarium and extracranial soft tissues are grossly unremarkable. Dedicated orbital sequences were not obtained however, there is asymmetric FLAIR hyperintensity involving the right optic nerve which may represent sequela of prior optic neuritis, which is more evident on prior MRI orbit study.Cervical spine: Multiple patchy foci of T2 hyperintensity in the cervical cord seen on prior imaging, particularly at the C3-C4 and C5-C7 levels are no longer appreciated. There is perhaps minimal residual T2 hyperintensity; however no discrete residual lesion is definitively appreciated. Cord parenchymal volume is maintained. Vertebral body heights and alignment are maintained. No significant disc disease. No spinal canal or neural foraminal stenosis. Bone marrow signal is benign.Thoracic spine: Patchy T2 hyperintensity seen in the thoracic cord is also essentially resolved. No discrete residual lesion in the thoracic cord is appreciated. Thoracic cord volume is preserved. Vertebral body heights and alignment are maintained. Bone marrow signal is benign. No spinal canal or neural foraminal stenosis is appreciated.
Compared to outside MRI from December 2015, there is marked improvement in previously seen extensive signal abnormality in the infratentorial brain, cervical cord and thoracic cord. No discrete residual lesion within the brain, cervical spine, or thoracic spine is appreciated. As such, prior findings may have represented a postinfectious inflammatory process/ADEM but can be correlated with clinical/lab findings. Dedicated orbital imaging was not obtained; however there is residual FLAIR signal abnormality involving the right optic nerve which may represent sequela of prior optic neuritis.