Female 59 years old with history of paresthesias, evaluate for demyelinating lesions Motion degradation limits evaluation. Limited sequences per demyelinating protocol were obtained. There are multiple ovoid foci of T2/FLAIR hyperintensity are seen with morphology and distribution compatible with known demyelinating disease. No prior study is available for comparison. Several of these lesions demonstrate T1 hypointensity. Volume loss in the posterior inferior right cerebellum suggestive of chronic infarct. An area of volume loss within the right frontal lobe with adjacent sulcal prominence extending into the operculum and adjacent FLAIR signal abnormality is also noted. There is also an area of decreased T2 signal within the left anterior temporal lobe subcortical white matter without mass effect.The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation.
1. Mild to moderate burden of T2/FLAIR supratentorial white matter lesions with distribution and morphology consistent with known demyelinating disease.2. Area of low T2 signal within the left anterior temporal lobe subcortical white matter, which is incompletely evaluated due to limited sequences per demyelinating disease protocol, but may be related to chronic hemorrhage or cavernous malformation. 4. Area of volume loss within the right frontal lobe with adjacent sulcal prominence extending into the operculum and adjacent FLAIR signal abnormality. This finding may represent chronic infarct or other chronic injury. Chronic infarct in the right posterior inferior cerebellar hemisphere is also suspected.5. No comparison studies are available, recommend obtaining prior studies or consider MRI brain.