62 years Male (DOB: 7/29/1953)Reason: rule out new lesion. History: increased l hand weaknessPROVIDER NAME: RAYMOND F ROOS RAYMOND F ROOS MRI brain:There is redemonstration of several subcortical and periventricular white matter lesions which are bright signal on FLAIR and T2 imaging. They have not changed since the prior exam. Additionally there is a T2 and FLAIR hyperintense punctate lesion at the left posterior lateral aspect of the pons near the middle cerebellar peduncle. This is also stable. No abnormal enhancing lesions are appreciated within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.MRI cervical spine:The cervical vertebral bodies are appropriate in overall alignment and height. There are multiple foci of T2 hyperintensity within the cervical spinal cord at the C1 level, C2 level at the C4 level, the C3 5 level and the C6 level which were also present on the prior exam. There is some atrophy of the cervical spinal cord present. No abnormal enhancing lesions are present in the cervical spinal cord. There is multilevel disc desiccation present. At C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there is redemonstration of a central disc extrusion as well as some ligamentum flavum hypertrophy. There is bilateral narrowing of the neural foramina due to disc material. This is not changed since the prior exam.At C4-5 there is no significant compromise to the spinal canal or neural foramina. There is a small right paramedian disc protrusion at this level. This is not changed since the prior exam.At C5-6 there is no significant compromise to the spinal canal or neural foramina. There is a disc bulge present at this level associated with narrowing of the neural foramina bilaterally and some encroachment of the exiting nerve roots. This is not changed since the prior exam.At C6-7 there is no significant compromise to the spinal canal or neural foramina. There is a disc bulge present at this level. This is not changed since the prior exam.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact.
1.There are multiple lesions within the cervical spinal cord associated with some atrophy of the cervical spinal cord which were also present on the prior exam. There is not appear to be any new lesions in the cervical spinal cord when compared to the prior exam. These are compatible with patient's clinical diagnosis of multiple sclerosis.2.There are multilevel degenerative changes present in the cervical spine which are stable compared to the prior exam with encroachment of exiting nerve roots at C3-4 and to a lesser degree at other levels.3.There are several small lesions within the brain parenchyma present which are stable compared to the prior exam. Their number is too small to establish a pattern. It is quite possible they are related to demyelinating disorder but they are nonspecific.