Evaluate for new demyelinating lesions. History of worsening right sided weakness, double vision. There is no evidence of acute ischemic infarction. There are extensive T2 hyperintense supratentorial and infratentorial lesions, which appear grossly unchanged compared to the MRI from 2015. Many of the lesions are also T1 hypointense, but there is no evidence of associated enhancement. There is no evidence of intracranial hemorrhage or mass. The pituitary gland appears unremarkable. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
1. No significant change in the extensive supratentorial and infratentorial demyelinating lesions.2. No evidence for acute ischemic infarction.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.