51 years Female (DOB:9/14/1964)Reason: MS, follow up progression History: paresthesiasPROVIDER/ATTENDING NAME: ADIL JAVED ADIL JAVED MRI brain:The CSF spaces are appropriate for the patient's stated age with no midline shift. There are multiple periventricular white matter lesions present which are high signal on T2 and FLAIR imaging. These are perpendicularly oriented to the lateral ventricles. There are subcortical T2 and FLAIR hyperintense lesions present cerebellar hemispheres bilaterally. There is also a T2 and FLAIR hyperintense focus present in the lower medulla.. There are a few supratentorially located subcortical white matter lesions present as well. Total number of cerebral white matter lesions is approximately 15.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. The cervical spinal cord has normal signal characteristics and overall morphology. There are multiple patchy T2 hyperintense foci present in the thoracic spinal cord. One is located the C1 vertebral level centered in the left hemicord. Another is at the right hemicord at the C2 level; another is at the left hemicord at the C4-5 disc level. Another one is located along the posterior central aspect of the spinal cord at the C5-6 level and another one along the left anterolateral aspect of the spinal cord at the C6 level. There is no associated mass effect with these lesions.At C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there is no significant compromise to the spinal canal or neural foramina.At C4-5 there is no significant compromise to the spinal canal. There is a disc bulge present at this level associated with uncovertebral osteophytes and encroachment of the exiting nerve roots more on the left than the right side.At C5-6 there is no significant compromise to the spinal canal. There is a disc bulge present at this level associated with uncovertebral osteophytes and encroachment of the exiting nerve roots more on the left than the right side.At C6-7 there is no significant compromise to the spinal canal or neural foramina.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact.Thoracic spine:The thoracic vertebral bodies are appropriate in the overall alignment and height. There is no compromise of thoracic spinal canal or exiting nerve roots. A T2 hyperintense focus is present along the right hemicord at the T9-T10. There is no associated mass effect.There is a left paramedian disc protrusion present at T8-9 which effaces spinal fluid ventral to the left hemicord. Smaller disc protrusions without significant CSF effacement are present at the right paramedian region at T7-8 and T9-T10.
1.There are multiple white matter lesions present within the brain and cervical spinal cord. These are suspected to be related to demyelination. 2.A spinal cord lesion located at the T9-10 level is associated with a disc protrusion that could also be related to demyelination.