51 years, Female, possible demyelinating disease. Fatigue, paresthesias. Evaluate for progression. Brain: Again seen are scattered T2/FLAIR hyperintense lesions in the subcortical as well as the periventricular white matter which are not significantly changed since 12/29/2015 although current study is of higher resolution limiting comparison of small lesions. In particular, small lesions are noted along the margins of the right temporal horn as well as along the callososeptal interface. Signal abnormality adjacent to the right temporal horn appears more prominent but this may be related to technique. No significant burden of T1 hypointense lesions. Brain parenchymal volume is preserved.No intracranial mass or mass effect. Ventricles and sulci are within normal limits. Major flow-voids are preserved. Calvarium and extra cranial soft tissues are grossly unremarkable. There is abnormal signal involving the left optic nerve compatible with history of prior optic neuritis and was present on prior study.Cervical spine: Craniovertebral junction appears within normal limits. The cervical vertebral bodies are appropriate in height. Alignment is maintained. No suspicious osseous lesion. The cervical spinal cord has normal signal characteristics and overall morphology.Degenerative changes are seen in the cervical spine as described below:C2-3: No significant compromise to the spinal canal or neural foramina.C3-4: There is mild right neural foraminal narrowing related to uncovertebral hypertrophy. Left neural foramen and spinal canal are patent. Findings are unchanged.C4-5: There is a disc osteophyte complex including uncovertebral hypertrophy on the right with moderate right-sided neural foraminal stenosis. Mild effacement of the ventral thecal sac without significant spinal canal stenosis overall. Left neural foramen is patent. Findings are unchanged.C5-6: There is a disc osteophyte complex with partial effacement of the ventral thecal sac. No significant spinal canal stenosis overall. There is mild left neural foraminal narrowing. Right neural foramen is patent. Findings are unchanged.C6-7: Disc osteophyte complex including a left foraminal disc protrusion and uncovertebral hypertrophy. Partial effacement of the ventral thecal sac without significant spinal canal stenosis overall. There is moderate to severe left and mild right neural foraminal stenosis. Mild right neural foraminal narrowing. Findings are not significantly changed.C7-T1: No significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits.
1. Allowing for slight differences in technique with current study of higher resolution, there is no significant change in mild burden of T2/FLAIR hyperintense lesions in the supratentorial white matter compared to 12/29/2015. The distribution and morphology of these lesions is overall nonspecific although few lesions such as along the right temporal horn are suggestive of demyelinating or prior inflammatory process. 2. No signal abnormality in the cervical cord to suggest demyelinating disease.3. Degenerative changes in the cervical spine without significant spinal canal stenosis at any level. There is up to moderate to severe left C6-C7 neural foraminal stenosis and milder neural foraminal stenoses at additional levels as detailed above. These findings are not significantly changed since 2/3/2015.4. Abnormal signal in the left optic nerve compatible with prior optic neuritis.