Transient alteration of awareness. History of multiple sclerosis, with reportedly previous MRI showing characteristic Dawson's fingers.IMAGE ACQUISITIONS: 5-mm contiguous axial CT sections of the brain without contrast infusion. No acute intracranial hemorrhage, mass effect or shift of midline structures. As on the previous head CT, there is multifocal white matter low attenuation, compatible with history of multiple sclerosis. There has likely been some interval progression compared to the previous CT scan, although the previous scan was somewhat degraded by patient motion and part of the apparent difference could be due to higher diagnostic quality of the current scan. There is no hydrocephalus. There are no subdural fluid collections.Some of the lesions in the left hemisphere are orientated anterior to posterior, which can be found with borderzone infarction, and the lesions are more prominent in the left hemisphere. It is not possible to definitively exclude superimposed ischemic lesions. If there is clinical concern for recent infarction or acute worsening of multiple sclerosis, MRI would be more sensitive.
1. No acute intracranial hemorrhage.2. slight interval worsening of white matter disease versus greater conspicuity of lesions due to motion artifact on the previous CT scan. Follow-up as indicated clinically.