Female, 35 years old, with left-sided weakness for three weeks and urinary incontinence. Brain:Numerous (greater than 20) T2 hyperintense lesions are identified within the juxtacortical and periventricular regions of both cerebral hemispheres, as well as within the brainstem and cerebellum. Many of these lesions are oriented radially with respect to the ventricles. Several of these lesions demonstrate corresponding enhancement. None is associated with significant local or regional mass effect. Brain parenchymal volume is relatively preserved. No significant generalized mass effect is seen. No evidence of acute or chronic intracranial hemorrhage is detected. The ventricles are normal in size and morphology.Spine:A T2 hyperintense lesion is evident occupying the left lateral and anterior aspects of the cervical spinal cord. This lesion spans from C1 to C2 and measures up to 25 mm in craniocaudal length. This lesion demonstrates minimal if any rim enhancement. A small T2 hyperintense lesion is evident within the anterior cord at the T8 level. An additional T2 hyperintense lesion is evident within the anterior spinal cord at the T11 level measuring up to 25 mm in length. This lesion demonstrates mild ill-defined enhancement. The nerve roots of cauda equina are within normal limits. No additional pathologic enhancement is seen. No epidural abnormalities are suspected.Spinal alignment is anatomic. Vertebral body height and morphology are within normal limits. No pathologic marrow replacement or marrow enhancement is seen. Scattered minimal disc protrusions are seen in the thoracic spine. No significant spinal canal or foraminal narrowing is evident at any spinal level.
Numerous intracranial and spinal cord lesions are identified showing morphology and distribution compatible with demyelinating disease. Some of these lesions are enhancing which would indicate active inflammation/demyelination.