Clinical question: Multiple sclerosis. Compared to prior exam. Signs and symptoms: Lower extremity numbness, right-sided weakness and blurry vision. Pre and post enhanced brain MRI: Examination demonstrate several chronic nonenhancing demyelinating plaques both in the supratentorial and infratentorial brain parenchyma without detectable abnormal enhancement. There is no convincing evidence of any new lesions since prior study. There is however mild interval decrease size of a few of the previously seen plaques since prior studyThe cerebral cortex, cortical sulci, ventricular system and CSF spaces are within normal for patient of stated age of 47 and without change since prior exam. The visualized cisternal component of bilateral optic nerves and the chiasm is unremarkable and without abnormal enhancement.Bilateral mastoid air cells, middle ear cavities and paranasal sinuses demonstrate normal pneumatization signal patterns.Pre- and post enhanced cervical MRI:Examination is performed utilizing multiple sclerosis protocol.Multiple previously seen demyelinating plaques of the lower medulla and the cervical spinal cord are again identified. The largest lesion similar to prior exam is at C2 level.There no convincing evidence of a new lesion and no detectable enhancing plaque. There is apparent change in cord caliber and similar to prior exam.Mild to moderate degenerative changes of the cervical spine without spinal stenosis similar to prior exam is again observed.
1.Brain table demonstrate chronic findings of demyelinating disease in both supra and infratentorial space without interval change or detectable enhancing plaque.2.Cervical MRI demonstrate stable finding of chronic nonenhancing demyelinating disease without change since prior exam. 