46 years Female (DOB:7/21/1969)Reason: Eval for demyelinating disease History: Tinnitus and paresthesiasPROVIDER/ATTENDING NAME: ADIL JAVED ADIL JAVED MRI brain:The CSF spaces are appropriate for the patient's stated age with no midline shift. There are periventricular and subcortical white matter T2 and FLAIR hyperintense lesions present approximately 15 in each hemisphere. The largest 1's appear to be in the left temporal lobe periventricular and subcortical white matter.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.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 demonstrate some mucosal thickening.. 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. 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. There is a subtle left paramedian disc protrusion at this level.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.Thoracic spine:The thoracic vertebral bodies are appropriate in the overall alignment. The thoracic spinal cord has normal signal characteristics and overall morphology. There is no compromise of thoracic spinal canal or exiting nerve roots. There is a small central disc protrusion at T7-8 and a right paramedian disc protrusion at T8-9.There is a mild superior endplate compression at T3.
1.Some periventricular white matter and subcortical white matter lesions are present which are nonspecific but given patient's clinical history could be related to demyelinating disease. Alternative considerations may include vascular related lesions including vasculitis as well as sarcoid and2.There are mild degenerative changes present in the cervical spine and thoracic spine without significant compromise to spinal canal or exiting nerve roots.3.No intrinsic lesions are appreciated within the thoracic spinal cord.4.No intrinsic lesions are appreciated in the cervical spinal cord.5.There is mild superior endplate compression at T3.