41 years Female (DOB:7/6/1975)Reason: MS? Brainstem lesion History: sudden L VI and IV palsy 6-2016PROVIDER/ATTENDING NAME: ANTHONY T. REDER ANTHONY T. REDER There is redemonstration of T2 and FLAIR hyperintense lesions several millimeters in size in the left anterior lateral medulla extending to the pontomedullary junction on its lateral aspect, the right posterior lateral medulla, the left fusiform gyrus subcortical white matter in the left half of the splenium of the corpus callosum. Additionally several punctate lesions are present in the periventricular white matter and subcortical white matter. The lesions in the midbrain appear more extensive on the current exam when compared to the previous exam. These lesions are hypointense on T1-weighted imagingNormal 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.
Lesions within the brainstem, corpus callosum, periventricular white matter and subcortical white matter are present. It is possible that the left sixth nerve fibers are affected. The possibility this is related to demyelinating process cannot be excluded. The lesions in the midbrain appear slightly more extensive on the current exam when compared to the previous exam. This perceived difference could be a result difference in imaging technique.