Reason: Evaluate for enhancing lesions. History: Suspected MS flare. Worsening blurry vision, ataxia, and left-sided numbness with mild weakness. The CSF spaces are appropriate for the patient's stated age with no midline shift. There is redemonstration of multiple periventricular white matter lesions many of which are oriented perpendicular to the lateral ventricles which are bright on flair and T2 imaging. Additional lesions with high signal on T2 and flair are present in the posterior limb of the right internal capsule throughout the brainstem and in the cerebellar hemispheres. There is no comparison study available. The lesion in the medulla measures 12.5 x 10 mm axial dimensions compared there are several periventricular white matter lesions which display a little bit of contrast enhancement. Additionally there is a left medial temporal lesion which displays contrast enhancement.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.Multiple periventricular, subcortical, cerebellar and brainstem lesions are present. These are suspicious for demyelinating disorder. There are several of these lesions are display contrast enhancement which is suggestive of more acute plaque formation