 MRI brain: There are multiple scattered foci of T2 FLAIR hyperintensity in the bilateral cerebral periventricular and subcortical white matter and in the pons, without significant interval change compared to prior exam. There is no associated postcontrast enhancement in any of these lesions. Most of these lesions are either undetectable or only mildly hypointense on T1 weighted images. No new lesions are seen.The ventricles and sulci are unchanged. The cisterns remain patent. There is no midline shift or mass effect. There is no diffusion abnormality. 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 cervical spine: The cervical spine is in normal alignment, with a normal cervical lordosis. The vertebral body and disk heights are well-maintained. No worrisome focal marrow signal abnormality is appreciated. The spinal cord is of normal caliber and signal. As before, the central canal of the spinal cord is mildly prominent in some areas, but this can be within the limits of normal variation. There is no pathological enhancement. There are scattered perineural cyst throughout the spine.C2-C3: No significant disc herniation, spinal canal stenosis or foraminal narrowing.C3-C4: No significant interval change. No significant spinal canal or foraminal stenosis.C4-C5: Disc osteophyte complex similar to prior. No interval change. There is moderate left neural foraminal narrowing. No significant spinal canal stenosis.C5-C6: Disc osteophyte complex, no significant interval change. Mild left neural foraminal narrowing. No significant spinal canal stenosis.C6-C7: Disc osteophytic complex and ligamentum flavum thickening resulting in moderate spinal canal stenosis, unchanged. Severe bilateral neuroforaminal narrowing remains unchanged.C7-T1: No significant disc bulge, herniation, spinal canal stenosis or neuroforamina narrowing.
1. Stable bilateral cerebral and pontine demyelinating lesions. No significant interval change in size or morphology compared to prior MRI from 6/25/2015. No enhancing lesions or new lesions are seen. 2. No evidence of demyelinating lesions in the spinal cord involving the cervical region.3. Stable degenerative changes in the cervical spine including moderate spinal canal stenosis and severe bilateral neural foramina narrowing at C6-C7.