32-year-old female with history of multiple sclerosis presenting with left upper extremity pain and left numbness from the chest wall to the foot, worsening gait. MRI BRAIN: There are approximately 20 T2/FLAIR hyperintense lesions within the periventricular and subcortical white matter with morphology and distribution compatible with known demyelinating disease. There is a lesion involving the left middle cerebellar peduncle extending to the superior cerebellar peduncle. There is mild burden of T1 hypointense lesions. Two of these lesions demonstrate enhancement, one of which is located within the right posterior temporal lobe and the other within the left parietal lobe.Brain parenchymal volume is grossly preserved. There is no mass effect or midline shift. There is no evidence of intracranial hemorrhage. The ventricles basal cisterns are normal in size and configuration.MRI CERVICAL SPINE: Straightening of the cervical spine likely related to patient positioning. The vertebral body and disk heights are well-maintained. No worrisome focal marrow signal abnormality is appreciated. There are two T2/STIR hyperintense lesions related to known demyelinating disease within the spinal cord along the left posterolateral aspect of C1 and the left posterior aspect of C2-C3 levels. The lesion along the posterior aspect of C2-C3 demonstrates enhancement consistent with active demyelination.There is no significant disk bulge, herniation, spinal canal or foraminal stenosis within the cervical spine.
Findings compatible with known demyelinating disease within the brain and upper cervical spinal cord. A left parietal, right posterior temporal, and a left C2-C3 cervical cord lesion demonstrate enhancement consistent with active demyelination. 