Multiple sclerosis. There are numerous, greater than ten, T2 hyperintense lesions involving the cerebral white matter. A lesion in the right frontal centrum semiovale has increased in size, while the other lesions do not appear to have significantly changed. The brain parenchyma and pituitary gland appear unremarkable. The presumed subcentimeter cystic pineal gland appears unchanged. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
Numerous cerebral white matter lesions are compatible with multiple sclerosis. A lesion in the right frontal centrum semiovale has increased in size, while the other lesions do not appear to have significantly changed.