48 years Female (DOB:3/6/1967)Reason: please do Dr Javed MS protocol, compare to prior History: MS progression, onTysabri, had speech arrest 9/15, concern for stroke vs PMLPROVIDER/ATTENDING NAME: JACQUELINE T BERNARD JACQUELINE T BERNARD The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a subcortical white matter lesion present in the left parietal lobe. It is hypointense on T1-weighted imaging. There are periventricular white matter FLAIR hyperintense lesions adjacent to the occipital horns of the lateral ventricles bilaterally. These were also present on the prior exam and are not hypointense on T1.No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.There is a new subcortical white matter lesion in the left parietal lobe. This is nonspecific especially in isolation. Differential considerations include MS plaque as well as other demyelinating lesions such as early PML.2.No abnormal enhancing lesions are appreciated to suggest acute or subacute plaque.