Multiple sclerosis: paresthesias. Brain: There are extensive supratentorial, and to a lesser degree infratentorial, white matter T2 hyperintense lesions. Many of the lesions are also T1 hypointense. Overall, the lesions appear to have progressed since 2013, accounting for differences in technique. There is no evidence of intracranial hemorrhage, mass, or acute infarct. The ventricles and basal cisterns are normal 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 unchanged.Cervical Spine: There is persistent scattered mild patchy T2 hyperintensity within the cervical spinal cord. There is irregularity of the dens, with what appears to be a chronic dens fracture or developmental malformation and associated hypertrophic changes that lead to compression of the spinal cord. There is multilevel degenerative spondylosis with up to mild spinal canal and neural foraminal stenosis. There are several small perineural cysts in the lower cervical and upper thoracic spine neural foramina. The vertebral bone marrow appears unchanged. The vertebral column alignment is intact. The vertebral body heights are preserved. The paraspinal soft tissues are unremarkable.
1. Extensive intracranial demyelinating disease related to multiple sclerosis. Overall, the lesions appear to have progressed since 2013, accounting for differences in technique. However, the degree of demyelinating disease in the cervical spine appears to be similar as in 2013.2. Irregularity of the dens, with what appears to be a chronic dens fracture or developmental malformation and associated hypertrophic changes that lead to compression of the spinal cord. 3. Multilevel degenerative spondylosis with up to mild spinal canal and neural foraminal stenosis. 