Female, 45 years old, with family history of multiple sclerosis and past medical history of optic neuritis and self-reported nonspecific white matter lesions. Scattered small foci of T2 hyperintensity are seen within the periventricular and, to a lesser extent, the subcortical white matter of both cerebral hemispheres. These lesions are largely punctate and not clearly radially oriented with respect to the ventricles. The corpus callosum is spared. Likewise, no definite lesions are seen in the brainstem or cerebellum.No evidence of parenchymal edema or mass effect is seen. Diffusion-weighted images are normal. No pathologic parenchymal or extra-axial enhancement is seen. No evidence of intracranial hemorrhage or any abnormal extra-axial fluid collection is seen. The ventricles are normal in size and morphology.
Multiple scattered small white matter lesions are seen in the supratentorial brain which are nonspecific by imaging criteria. These could potentially represent demyelinating lesions, though the differential would also include sequelae of prior inflammation, vasculitis, and migraine headaches among others.