40 years Female (DOB:10/5/1975)Reason: interval change History: Lhermitte'sPROVIDER/ATTENDING NAME: ANTHONY T REDER ANTHONY T REDER MRI brain:The CSF spaces are appropriate for the patient's stated age with no midline shift. There is redemonstration of patchy T2 and FLAIR hyperintense lesions located in the periventricular white matter as well as the T2 and FLAIR hyperintense foci in the left cerebral peduncle, the left superior cerebellar peduncle and along the anterior medial medulla. There are a few punctate lesions present in the right cerebellar hemisphere which were also present on the prior exam. The lesion along the medulla appears to have increased in extent and now extends down into the cervical spinal cord. The other lesions appear to be relatively stable.Findings raise the question of possible lesion in the left optic nerve at the canalicular segment. It is not clear whether this was present on the prior exam.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. The cervical spinal cord has normal signal characteristics and overall morphology. There are patchy ill-defined lesions located within the cervical spinal cord at the C1 level, the C3 to level, the C3-C4, C5, C6, C7 and the visualized upper thoracic levels. These lesions appear to be predominantly along the near midline aspects of the cervical spinal cord.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. There is a disc bulge at this level.At C4-5 there is no significant compromise to the spinal canal or neural foramina. There is a disc bulge at this level.At C5-6 there is no significant compromise to the spinal canal or neural foramina. There is a disc bulge at this level.At C6-7 there is no significant compromise to the spinal canal or neural foramina. There is a disc bulge at this level.At C7-T1 there is no significant compromise to the spinal canal or neural foramina. There is a disc bulge at this level.There is a disc bulge at T1-T2.The vertebral artery flow voids appear to be intact.
1.Since the prior exam the lesion located in the medulla has extended inferiorly into the upper cervical spinal cord.2.There are multiple lesions scattered in the supratentorial and infratentorial brain as well as the cervical spinal cord as detailed above which are concerning for demyelinating process.