63-year-old male with worsening gait There is no evidence of intracranial hemorrhage, mass, or acute infarct. Redemonstrated are T2 hyperintense foci within the brainstem, periventricular and subcortical white matter, some of which have a radiating appearance, not significantly changed. However, there is a new focus within the anteromedial right thalamus which demonstrates susceptibility artifact suggesting interval, yet remote in appearance, microhemorrhage. There is stable mild volume loss and prominence of the cerebellar folia. The corpus callosum appears to be focally thinned in certain areas, unchanged in extent. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. As before, there are maxillary retention cysts, opacification of the right sphenoid sinus and mucosal thickening within a posterior ethmoid air cell, stable. There is new opacification within a pneumatized air cell located just anterior to the right glenoid fossa.
1.No evidence of acute intracranial hemorrhage, mass, or acute infarct. 2.Redemonstrated is T2 brainstem, periventricular and subcortical hyperintensity, stable in appearance. The morphology is suggestive of a demyelinating disease, but other etiologies such as vascular disease and prior inflammation are not excluded.3.There is a new focus within the anteromedial right thalamus which demonstrates susceptibility artifact suggesting interval, yet remote in appearance, microhemorrhage.