50 years Female (DOB: 6/29/1965)Reason: Multiple Sclerosis History: assess progression and new inflammatory activityPROVIDER NAME: ADIL L JAVED ADIL L JAVED MRI brain:There is an extra-axial mass measuring 15 x 10 mm coronal dimensions adjacent to the left central sulcus. It has a broad-based the dura. It is stable compared to the prior exam.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.There are several punctate subcortical white matter lesions present in the parietal lobes bilaterally. There are bright on FLAIR and T2 MRI. There is a punctate FLAIR hyperintense lesion located adjacent to the left orbital gyrus. An additional lesion is present in the subcortical white matter of the right parahippocampal gyrus. These were also present on the prior exam not substantially changed. There is a lesion the subcortical white matter of the anterior aspect of the right temporal lobe which is smaller on the current exam when compared to the prior. It previously measured approximately 6 mm and now measures approximately 3 mm.There is FLAIR signal hyperintensity along the surface of the brainstem as well as the medial aspects of the middle cerebellar peduncles and within the midbrain centrally. There is a vague signal hyperintensity on T2 and FLAIR along the precentral gyri bilaterally and the left middle frontal gyrus subcortical white matter bilaterally. These findings are stable compared to the previous exam.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.MRI cervical spine:The cervical vertebral bodies are appropriate in overall alignment and height. The cervical spinal cord has normal signal characteristics and overall morphology. No abnormal enhancing lesions are identified in the cervical spine.At C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there is no significant compromise to the spinal canal or neural foramina. There is a disc bulge present this level.At C4-5 there is no significant compromise to the spinal canal or neural foramina. There is a minor disc bulge present at this level.At C5-6 there is loss of disc space height, disc desiccation and diffuse disc bulge associated with mild narrowing of the neural foramina bilaterally and effacement of spinal fluid ventral and posterior the spinal cord. Overall there is a mild degree are spell stenosis at this level.At C6-7 there is loss of disc space height, disc desiccation and diffuse disc bulge associated with mild narrowing of the neural foramina bilaterally and effacement of spinal fluid ventral and posterior the spinal cord. Overall there is a mild to moderate degree are spell stenosis at this level.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact.
1.There are vague patchy lesions present in the subcortical white matter of the postcentral gyri and left middle frontal gyrus associated with some signal changes along the brainstem which were also present on the prior exam. It is conceivable this is related to demyelination. It is stable compared to prior exam.2.There are subcortical white matter lesions scattered within the brain parenchyma which for the most part are stable. One in particular in the right temporal lobe has decreased in size. These are nonspecific. It could be related to demyelination.3.An extra-axial mass adjacent to the left central sulcus most likely represents meningioma.4.There are degenerative changes present in the cervical spine with mild to moderate spinal stenosis at C6-7 and mild spinal stenosis at C5-6..