39-year-old female with right-sided weakness and facial droop. Evaluate for acute infarct. MRI Brain:There is no evidence of intracranial hemorrhage, mass, or acute infarct. Redemonstrated are several foci of T2/FLAIR hyperintensity within the supratentorial periventricular and subcortical white matter. These include few foci along the bilateral corpus callosal bodies as well as a juxtacortical lesion along the right parietal lobe. There is no significant change in the interval. No new lesions are appreciated.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 grossly unremarkable.MRI C-Spine:Again demonstrated is abnormal T2/STIR hyperintense cord signal involving the right posterolateral aspect of the spinal cord at the C3-4 level as well as a second smaller lesion again involving the right lateral aspect of the cord at the C5 level. The C3-C4 lesion appears slightly larger with increased cranial extension. There also appears to be enhancement involving the superior aspect of this lesion.There are otherwise no new lesions or abnormal enhancement elsewhere in the cervical cord.The cervical spine alignment is maintained and the cervical vertebral bodies are appropriate in height. There are mild degenerative changes are relatively more prominently involving the C5-6 level where there is a small disc osteophyte but there is no significant spinal canal or neural foraminal stenosis at any level. The bone marrow signal is within normal limits. The vertebral artery flow voids appear to be intact. The paraspinous soft tissue structures appear within normal limits.
1. No significant change in several scattered supratentorial T2/FLAIR hyperintense lesions including two small foci along the corpus callosum and a right parietal juxtacortical lesion which are suggestive of demyelinating disease. No new lesions in the brain or abnormal enhancement to suggest active demyelination in the brain.2. There is increase in cranial extent of T2 signal abnormality associated with a previously seen C3-C4 lesion. There is also associated enhancement, findings which are suspicious for active demyelination adjacent to a chronic demyelinating plaque. Smaller right C5 lesion also again seen. Dr. Ali discussed findings with Dr. Burns at 1005 hours on 12/12/2016.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.