Multiple sclerosis. Numbness, chest tightness. Please do Dr Javed MS protocol, and compare to uploaded MRI from outside MRI brain:The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a mild to moderate degree of periventricular and subcortical white matter lesions which are bright on T2 and FLAIR MRINo abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma which are mostly unchanged since the prior exam. A lesion adjacent to the temporal horn of the right lateral ventricle which enhances following contrast administration is new since the prior exam. A small lesion in the right pons now enhances following contrast administration.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.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.The patient has multiple periventricular white matter and subcortical white matter lesions as well as a couple brainstem lesions which were also present on the prior exam and are mostly unchanged, however, there is a new lesion adjacent ot the temporal horn and a previously present lesion in the right pons which display contrast enhancement suggesting that they are active.2.No cervical spinal cord lesions are identified to suggest cervical spinal cord involvement.