History of multiple sclerosis; presenting with paresthesias. Again seen are numerous T2 hyperintense supratentorial and infratentorial lesions. There are areas which appear confluent, with perpendicular orientation with respect to the lateral ventricles. There is a new T2 hyperintense lesion in the left corona radiata, which partially enhances. The previously seen area of enhancement in the left subinsular cortex has resolved. The remainder of the lesions are stable, including brainstem involvement, and possibly along the left brachium pontis. There is no evidence of intracranial hemorrhage or acute infarction. The pituitary gland is unremarkable. The ventricles and basal cisterns are unchanged. There is no midline shift or herniation. The major cerebral flow voids are intact. Cosmetic fillers again noted in the bilateral nasolabial folds.
Multiple supratentorial and infratentorial demyelinating lesions consistent with history of multiple sclerosis, including a new T2 hyperintense lesion which partially enhances in the left corona radiata, compatible with an acute/active lesion. Previous enhancement associated with a left subinsular region lesion has resolved. There is mild to moderate T1 burden and moderate to severe T2 burden of disease.