22 years, Female, hx of MS here w leg weakness, blurred vision, R hand tremor, eval for PMS vs MS vs acute process Again seen are multiple T2/FLAIR hyperintense lesions in the periventricular and subcortical white matter throughout the bilateral cerebral hemispheres with morphology and distribution consistent with known demyelinating disease. There has been increase in size of multiple foci of enhancement (greater than 20) and T2/FLAIR hyperintensity associated with the lesions seen on recent MRI from 11/9/2016. A dominant tumefactive lesion in the left centrum semiovale again demonstrates small focus of enhancement as before but otherwise unchanged.Several posterior fossa lesions including the left middle cerebellar peduncle along the right lateral aspect of the fourth ventricle as well as left cerebellar hemisphere are similar to prior and do not demonstrate enhancement. There is a relatively mild burden of T1 hypointense lesions. Brain parenchymal volume is preserved.No intracranial mass effect, midline shift, or herniation. Ventricles are normal in size. There is also abnormal signal involving the partially imaged cervical cord with multiple foci of enhancement including the C2 and C4-C5 levels which are more conspicuous than on prior from 11/9/2016 although can be better assessed with dedicated cervical spine MRI.
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