Diagnosis: Multiple sclerosisClinical question: please do Dr. Javed MS protocol and compare to priorSigns and Symptoms: headaches, weakness The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a moderate degree of T2 and FLAIR hyperintense small periventricular white matter lesions which are perpendicularly oriented to the lateral ventricles. These are stable compared to the prior exam. Additionally there are a few T2 and FLAIR hyperintense subcortical white matter lesions present which are also stable compared to the prior exam. There are T2 and FLAIR hyperintense white matter lesions present within the internal capsules which were also present on the prior exam.There is a punctate right thalamic lesion present which can be identified on the prior exam from 3/19/2013.Ill-defined signal T2 and FLAIR hyperintensities within the brain stem also remains stable. A couple punctate T2 and FLAIR hyperintense lesions in the cerebellum are also stable.No abnormal enhancing lesions are appreciated within the brain parenchyma.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.
There is redemonstration of white matter lesions scattered throughout the supratentorial brain and brainstem which have been stable since prior exams.