31 years Female (DOB: 7/21/1984)Reason: Eval for progression; CLIPPERS History: gait ataxiaPROVIDER NAME: ADIL JAVED ADIL JAVED MRI brain:The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma. There are several punctate foci of FLAIR signal hyperintensity in the subcortical white matter of the right hemisphere and to a lesser degree left hemisphere which are not clearly associated with any contrast enhancement. The largest appears to be in the left middle temporal gyrus subcortical white matter. Compared the prior exam the have not changed substantially.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.MRI cervical spine:The cervical vertebral bodies are appropriate in overall alignment and height. The cervical spinal cord has normal signal characteristics and overall morphology. No abnormal enhancing lesions are identified in the cervical spine. Multiple punctate foci of enhancement are present along the peripheral surface of the spinal cord at the from the cervical medullary junction down to the C6 vertebral level. These were also present on the prior exam . Some patchy foci of spinal cord signal hyperintensity along the posterior lateral aspects of the spinal cord especially at the C2 and C3 vertebral body levels but also at C5 are somewhat less conspicuous than on prior exams.At C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there is no significant compromise to the spinal canal or neural foramina.At C4-5 there is no significant compromise to the spinal canal or neural foramina.At C5-6 there is no significant compromise to the spinal canal or neural foramina.At C6-7 there is no significant compromise to the spinal canal or neural foramina.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact.
1.There is a mild degree of periventricular, internal capsule and subcortical white matter lesions are stable relative to the prior exam.2.Since prior exams the number of enhancing spinal cord lesions and lesions which are also present on the prior exams which are associated with a less T2 signal hyperintensity on the current prior exam.