Multiple sclerosis. Follow up progression MRI brain:The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a mild degree of subcortical and to a lesser degree periventricular punctate hyperintense white matter lesions present identified on the FLAIR and T2 images. They are unchanged since the previous exam from February 2014.No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.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.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. There is a T2 hyperintense lesion present along the anterior aspect of the left to side of the cervical spinal cord associated with some focal volume loss. This is unchanged since the previous exam from February 2014.No abnormal enhancing lesions are identified in the cervical spine. The patient status post anterior fusion at C6-7 with anterior plate and screws as well as bone plug.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.At C4-5 there is no significant compromise to the spinal canal or neural foramina.At C5-6 there is no significant compromise to the spinal canal or neural foramina.At C6-7 there is no significant compromise to the spinal canal or neural foramina.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.Myelomalacia involving the left hemicord at C7. This is unchanged since the previous exam from February 2014.2.Periventricular and subcortical white matter signal changes of a mild degree are present which are nonspecific. They could be vascular related, related to demyelination, trauma, vasculitis, sarcoid. They are nonspecific. They are unchanged since the previous exam from February 2014.