 MRI BRAIN:There are numerous foci of increased T2 signal involving the corpus callosum and supratentorial periventricular white matter, many oriented perpendicular to the lateral ventricles. Additionally, there are T2 hyperintense foci in the bilateral cerebellum, left dorsal medulla, and left middle cerebellar peduncle. There is no definitive restricted diffusion associated with these lesions.The ventricles and sulci are within normal limits. The basal cisterns remain patent. There is no midline shift or mass effect. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. MRI ORBITS:There is mild asymmetric enhancement and subtle corresponding increased T2 signal within the anterior right optic nerve. There is also questionable increased size of the right optic nerve. There is no definite involvement of the optic chiasm.The left optic nerve is within normal limits. The optic tracts appear normal. The extraocular muscles are normal and symmetric with physiologic, homogeneous, and intense contrast enhancement. The globes appear normal with physiologic enhancement of the ciliary bodies and choroid. No orbital mass lesion.
1.Asymmetric abnormal enhancement and edema involving the perhaps mildly prominent intraorbital right optic nerve is most suggestive of optic neuritis.2.Numerous T2 hyperintense foci in the corpus callosum, supratentorial periventricular white matter, cerebellum and medulla, most suggestive of demyelinating disease, with overall mild T1 and T2 burden disease. Post contrast images of the brain were not obtained to assess for enhancement.