Multiple sclerosis: Bilateral lower extremity weakness.. Brain: There are numerous supratentorial and to a lesser degree infratentorial white matter T2 hyperintense lesions, which have overall progressed in size and number since 2013. In addition, there are newly apparent subcentimeter foci of enhancement in the white matter adjacent to the right temporal horn, the subcortical white matter of the inferior temporal gyrus, and in the anterior right lateral periventricular white matter. Otherwise, a focus of enhancement in the inferior right frontal lobe has resolved. Many of the lesions display T1 hypointensity. There is no evidence of intracranial hemorrhage, mass, or acute infarct. The ventricles and basal cisterns are unchanged 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.Cervical Spine: There are a few scattered foci of T2 hyperintensity throughout the cervical spinal cord and imaged upper thoracic spinal cord, but no associated enhancement or expansion. There is lack of the usual cervical lordosis, but no spondylolisthesis. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is unremarkable. There is no significant spinal canal stenosis. The paravertebral soft tissues are unremarkable.
1. Numerous intracranial demyelinating lesions have overall progressed in size and number since 2013, with several new foci of acute inflammation in the right cerebral hemisphere.2. Multiple demyelinating lesions in the imaged portions of the spinal cord without acute inflammatory manifestations.