Reason: f/u of ADEM vs NMO spectrum, p/w L sided numbness, R abducens palsy, HA History: f/u of ADEM vs NMO spectrum, p/w L sided numbness, R abducens palsy, HA. Brain: There has been marked interval decrease in the extent of signal abnormality within the brainstem, with a residual subcentimeter focus of high T2 signal in the right paramedial posterior pontomedullary junction. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift. There are unchanged mildly low-lying and pointed cerebellar tonsils. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.Cervical Spine: There are persistent subcentimeter foci of high T2 signal in the spinal cord at the level of C3 on the right and C6 on the left. There is no evidence of abnormal enhancement within the cervical spine. 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 or neural foramen stenosis. The paravertebral soft tissues are unremarkable.
1. Interval decrease in size of the demyelinating or inflammatory lesion within the brainstem and persistent lesions within the cervical spinal cord. 2. Unchanged mildly low-lying and pointed cerebellar tonsils, which may represent Chiari I malformation. 