Paresthesias, multiple sclerosis. Follow-up progression. Javed MS protocol. Brain: There are approximately 20 foci of T2/FLAIR hyperintensity in the bilateral periventricular and subcortical white matter with distribution and morphology compatible with known demyelinating disease. Several of these foci are associated with T1 hypointensity. Infratentorial lesions including the left aspect of the midbrain and left cerebellar hemisphere also noted. Compared to 3/19/2015, there is no new lesion to suggest disease progression. Brain parenchymal volume is preserved. No evidence of intracranial mass or mass effect. No hydrocephalus or extra-axial collections. Calvarium and extracranial soft tissues are unremarkable.Cervical Spine: There are T2 hyperintense lesions in the cord compatible with known demyelinating disease including the ventral C4 level in the midline and the dorsal T1-T2 level. These lesions were present on prior study. No new lesions to suggest disease progression. There is mild loss of of cervical lordosis. Vertebral body heights and alignment are otherwise maintained. Minimal disc protrusions are present such as at the right paracentral C3-C4 and left paracentral C5-C6 levels. There is no significant spinal canal or neural foraminal stenosis at any level. Bone marrow signal is unremarkable.
Multiple T2/FLAIR hyperintense lesions in the brain, cervical, and partially imaged upper thoracic cord as described above are consistent with known chronic demyelinating disease. Compared to 3/19/2015, no new lesions are seen to suggest disease progression. 