56 years Female (DOB:1/5/1960)Reason: MS, eval for progression History: paresthesiasPROVIDER/ATTENDING NAME: ADIL JAVED ADIL JAVED MRI brain:The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a T2 hyperintense lesion present within the left middle cerebellar peduncle There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images. These are stable compared to the previous examNo abnormal 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 are patchy T2 hyperintense lesions present throughout the cervical spinal cord which were also present on the prior exam it did not appear to have changed substantially. These are located at the C1, C2, C3 and C4 levels along the posterior aspect of the spinal cord.At C2-3 there is no significant compromise to the spinal canal or neural foramina. There is a mild disc bulge at this level.At C3-4 there is no significant compromise to the spinal canal or neural foramina. There is a disc bulge at this levelAt C4-5 there is no significant compromise to the spinal canal or neural foramina. There is a broad-based central disc protrusion present at this level which effaces spinal fluid ventral and posterior the spinal cord creating mild spinal stenosis.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.There are multiple lesions in the brain and cervical spinal cord which are compatible with demyelinating disorder. These are stable compared to the previous exam from April2.There are some degenerative changes present in the cervical spine which are worse at C4-5 where there is a mild degree of spinal stenosis. This is stable compared to the prior exam.