Multiple sclerosis, pain, visual blurring. There are greater than 20 T2/flair hyperintense lesions involving the bilateral periventricular and subcortical white matter. Most of these lesions demonstrate a morphology and distribution characteristic of known demyelinating disease. More confluent FLAIR signal abnormality is noted in the bilateral periatrial regions and along the temporal horns. Small infratentorial lesions including the right superior and middle cerebellar peduncle are also seen. Several lesions with low T1 signal also noted. There is mild global parenchymal volume loss including the cerebellum as well as hypoplasia involving the inferior cerebellar vermis which is incidentally noted. No intracranial mass or mass-effect. No hydrocephalus or extra-axial collections. Major flow-voids are preserved.Dedicated sequences were not obtained however orbits and sella are grossly unremarkable. There is possible T2/FLAIR hyperintensity at the level of the chiasm and optic tracts which can be confirmed with coronal T2 sequences. Paranasal sinuses and mastoid cells are clear. Calvarium is intact. Extracranial soft tissues are within normal limits.
1. Numerous T2/FLAIR hyperintense lesions consistent with known demyelinating disease. Possible FLAIR hyperintensity at the level of the chiasm and bilateral optic tracts which may be artifactual but can be confirmed with coronal T2 sequences. Please note prior MRI is not available for comparison and an addendum can be issued if it is made available to the radiology department.2. Please note only MRI brain without contrast was obtained. Patient could not tolerate further imaging and postcontrast brain sequences as well as cervical spine study was not performed.