Female, 47 years old, with history of multiple sclerosis and ataxia. Brain:Extensive, confluent T2 hyperintensity is evident within the juxtacortical and periventricular white matter of the cerebral hemispheres. Lesions are associated with moderate to marked T1 hypointensity. Lesions in the pons and cerebellum are much more subtle. Marked callosal thinning and generalized cerebral volume loss is noted with corresponding ventricular prominence. No abnormal fluid collections are seen.C-spine:Patchy ill-defined T2 hyperintensity is evident throughout the visualized cervical spinal cord. A more focal appearing T2 hyperintense lesion dorsally at C6-7 could represent a small area of cystic degeneration or simply a more circumscribed lesion. A small focal central disc osteophyte complex at C3-4 mildly impinges on the spinal cord. A small focal central disc osteophyte complex at C6-7 is present without cord impingement. No significant foraminal narrowing is detected.
Evidence of extensive long-standing demyelinating disease is seen in the brain and in the visualized spinal cord.