Left-sided paresthesias, word finding difficulties, concern for MS, previous MRI due to left-sided paresthesia for weeks with T2 FLAIR hyperintensities. No diffusion restriction is seen to suggest acute ischemia. No susceptibility weighted artifact is seen to suggest intracranial hemorrhage. Scattered T2/FLAIR hyperintense foci are seen in the periventricular and subcortical white matter, unchanged from the prior study. No enhancement is seen associated with these lesions. No lesions are seen within the posterior fossa. No new lesions are identified. No abnormal areas of enhancement are seen. The CSF spaces are appropriate for the patient's stated age with no midline shift. Prominent perivascular spaces are seen in the right inferior basal ganglia. Normal vascular flow voids are present in the major intracranial vasculature.The imaged portions of the paranasal sinuses are clear. The imaged portions of the mastoid air cells are clear. The imaged portions of the orbits are intact.
Nonspecific T2/FLAIR hyperintense foci are unchanged. Differential diagnosis most likely includes demyelinating disease, migraine sequela, diffuse axonal injury, and small vessel ischemic disease. 