Multiple sclerosis with optic neuritis. Brain: There are numerous T2 hyperintense lesions in the supratentorial and infratentorial white matter, While some of the lesions appear to be less conspicuous and associated enhancement has resolved, such as in the left inferior left frontal gyrus subcortical white matter and bilateral periventricular white matter, there is persistent enhancement associated with the right gyrus rectus subcortical white matter lesion and newly apparent enhancement and mild swelling of the left prechiasmatic optic nerve segment ad left aspect of the optic chiasm. There is no evidence of intracranial hemorrhage, mass, or acute infarct. The ventricles are unchanged in size and configuration, with mild diffuse cerebral volume loss. There is no midline shift or herniation. The major cerebral flow voids are intact. There is mild mucosal thickening and abundant secretions in the right maxillary sinus. The skull and scalp soft tissues are grossly unremarkable.Orbits: There is no evidence of abnormal signal or enhancement of the intraorbital optic nerves. The bilateral globes, lacrimal glands, extraocular muscles, and orbital fat appear unremarkable. There is no evidence of intraorbital mass lesions.Cervical Spine: There has been overall interval decrease in the degree of swelling and conspicuity related to multiple T2 hyperintense lesions in the cervical spinal cord. There is a persistent subcentimeter focus of enhancement in the left spinal cord at the level of the dens, but otherwise interval resolution of other areas of enhancement in the spinal cord. The vertebral column alignment is within normal limits. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is unremarkable. There is no significant spinal canal stenosis. The paravertebral soft tissues are unremarkable.
1. Numerous intracranial demyelinating lesions with overall decrease in the associated enhancement, although enhancement associated with the right gyrus rectus subcortical white matter lesion persists and enhancement and mild swelling of the left prechiasmatic optic nerve segment ad left aspect of the optic chiasm is newly apparent.2. Decreased edema associated with multiple demyelinating lesions in the cervical spinal cord, along with overall interval decrease in the associated enhancement, although a small area of enhancement in the left spinal cord at the level of the dens persists.3. Findings suggestive of acute right maxillary sinusitis.