Diagnosis: Multiple sclerosisClinical question: MS, f/u progressionSigns and Symptoms: paresthesias There is redemonstration of multiple signal hyperintense lesions throughout the brain. One in the anterior aspect of the left medulla and one in the posterior lateral aspect of the right medulla were present were also present on the prior exam. One in the right cerebellar hemisphere and another in the left middle cerebellar peduncle are also unchanged. Confluent periventricular white matter lesions are perpendicularly oriented to the lateral ventricles are also redemonstrated and have not changed substantially. There is extension into the aspect of the corpus callosum. Additionally there are lesions extending down to the centrum semiovale and additional lesions in the subcortical white matter of the frontal lobesNormal 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 demonstrate mucosal thickening in the right maxillary sinus and a large mucous retention cyst in the left maxillary sinus.. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
Extensive periventricular, subcortical, brainstem and cerebellar lesions are stable compared to the prior exam from 4/27/1915. These are compatible with patient's diagnosis of multiple sclerosis.