 Brain: There is a 30 mm diameter smooth, incomplete peripherally-enhancing, cystic left temporoparietal lesion with surrounding confluent T2 hyperintensity. There is disproportionate paucity of mass effect for the size of the lesion. There are also multiple, greater than 10, subcentimeter periventricular and pericallosal T2 hyperintense white matter lesions. Some of these lesions demonstrate patchy enhancement. There is no evidence of acute hemorrhage or infarction. The ventricles and sulci are within normal limits. There is no midline shift or mass effect. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable. Cervical Spine: The spinal cord displays normal signal. There is normal cervical lordosis. The cervical spine alignment is anatomic. The vertebral body heights are preserved. The bone marrow signal is unremarkable. There is mild degenerative spondylosis at C3-4 through C5-6, with mild spinal canal, but no significant neural foraminal narrowing. The paraspinal soft tissues are unremarkable. There is no evidence of abnormal enhancement, cord compression or mass.
1. Multiple periventricular and pericallosal white matter lesions, including enhancing lesions, likely represent a demyelinating process with acute inflammatory lesions. A large, smooth, incomplete peripherally-enhancing, cystic left temporoparietal mass with surrounding vasogenic edema may represent an associated pseudotumor cystic demyelinating plaque in the setting of other demyelinating lesions. Neoplasm is a less likely differential consideration.2. No evidence of cervical spinal cord lesions.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.