History of Crohn's disease, on Humira. Presented with 2-week history of left-sided numbness, mild weakness. Evaluate for demyelinating syndrome. Brain:Brain parenchyma appears within normal limits, specifically without signal abnormalities to suggest demyelinating disease. There is no mass-effect or midline shift. There is no contrast enhancing brain lesion. The ventricles and the other CSF-containing spaces are normal in size. The major intracranial vessels are patent. There is also no abnormality on diffusion- or susceptibility-weighted imaging.Orbits are normal. Mastoid air cells and paranasal sinuses are clear. There is no destructive skull lesion. The pituitary gland is prominent which is appropriate for patient's age.Cervical Spine:The cervical spinal cord also shows normal morphology and signal characteristics. There is no abnormal spinal cord or leptomeningeal contrast enhancement.Cervical spinal alignment is notable for straightening which may reflect patient position. The vertebrae are of normal morphology with preserved body height. The marrow signal shows no suspicious lesions. The cervical spinal canal is preserved with no compression of the thecal sac. The neural foramina are also patent without significant degenerative disease at any level.Included cervical soft tissues are notable for incidental Thornwald cysts in the nasopharynx. There are also small lymph nodes in the upper neck that are probably reactive. The left thyroid lobe is smaller than the right. Thoracic Spine:Thoracic spinal cord also shows normal morphology and signal characteristics. The postcontrast images are mildly degraded by motion but there is no gross abnormal contrast enhancement. The spinal canal is preserved as well as the neural foramina without stenoses. The thoracic vertebrae as well as L1 show normal alignment, morphology and marrow signal characteristics. Included paraspinal soft tissues show no gross abnormality neither.
1.Brain parenchyma appears within normal limits without evidence of demyelinating disease.2.No abnormal signal in the cervical or thoracic cord.