Progressive multiple sclerosis. There is no significant interval change in the size and number of cerebral white matter T2 hyperintense lesions. Many of the lesions are also T1 hypointense. There is also unchanged faint patchy enhancement associated with a right anterior cingulate gyrus lesion. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift. There are unchanged mildly low-lying cerebellar tonsils. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
No appreciable interval change in the numerous demyelinating lesions in the brain.