55 years Female (DOB: 2/9/1961)Reason: weakness, waxing and waning, History: MS with increased weaknessPROVIDER NAME: SANDEEP PULIMI CHRISTINE S JUN MRI brain:There is redemonstration of multiple periventricular and subcortical T2 and FLAIR hyperintense and T1 hypointense small lesions some of which are perpendicular to the lateral ventricles. There are additional lesions redemonstrated in the right thalamus and right posterior pons. These appear stable since 12/24/15. There is no associated contrast enhancement with these lesionsNormal 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. There is redemonstration of multiple T2 hyperintense lesions in he cervical spinal cord at the C2 level right posteromedian, the C4 level right posterolateral and C5-6 level posterior midline. No abnormal enhancing lesions are identified in the cervical spine. There is straightening of the normal cervical curvature.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 neural foramina. There is a broad based disk protrusion at this level partially effacing CSF ventral and posterior to the spinal cord. There is loss of disk space height and disk dessication. There is mild to moderate spinal stenosis at this level.At C5-6 there is no significant compromise to the spinal canal or neural foramina. There is a disk bulge and disk dessication at this level.At C6-7 there is no significant compromise to the neural foramina. There is a disk bulge and disk dessication at this level associated with partial effacement of spinal fluid ventral and posterior to the spinal cord compatible with mild spinal stenosis.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact.Thoracic spine:The thoracic vertebral bodies are appropriate in the overall alignment and height. There is a T2 hyperintense lesion along the posterior aspect of the spinal cord at the C6-7 level associated with local atrophy. This can be identified in 2009. Smaller lesions are present in the right posterolateral cord at C1 and C3-C4. These seen on the 2009 exam. There is no compromise of thoracic spinal canal or exiting nerve roots. No abnormal enhancing lesions are identified in the thoracic spine.
1.Periventricular, subcortical right thalamic and right pontine lesions compatible with demyelination are stable since December.2.There are multiple spinal cord lesions compatible with demyelination. These are stable since last March3.There are degenerative changes in the cervical spine with mild to moderate spinal stenosis at C4-5. These are stable since last March4.There are several thoracic spinal cord lesions present compatible with demyelination. These are unchanged since 2009.