33-year-old female patient with weakness in the bilateral lower extremities, extreme gastroparesis, and numbness in extremities. Evaluate for multiple sclerosis. BRAIN: There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma and pituitary gland appear unremarkable. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. There is mild prominence of the optic nerve sheaths. There is a left maxillary sinus mucous retention cyst. SPINE: There is no cord signal abnormality or enhancement within the cervical, thoracic, or lumbar spine. Alignment is anatomic throughout the spine. Vertebral body height and disc spaces are preserved. There is no significant spinal canal stenosis or neural foraminal stenosis.There is a partially imaged nasogastric tube with fluid within the posterior nasopharynx. There is non-specific sclerosis (low T1 and T2 signal) about the sacroiliac joints without evidence of edema, which could reflect osteitis condensans ilii. There is a subcentimeter low T2 signal intensity lesion within the uterine fundus; this is non-specific and can be further evaluated with dedicated pelvic imaging if clinically warranted.
1. No obvious lesion within the brain or spine to account for the patient's symptoms.2. Mild prominence of the optic nerve sheaths is non-specific and can be a normal finding, but has also been reported in the setting of increased intracranial pressure due to various etiologies including pseudotumor cerebri. 