Demyelinating disease: right sided numbness and hyperreflexia. Brain: Thre are multiple, greater than 10, supratentorial and infratentorial T2 hyperintense white matter lesions. A lesion in the right superior frontal gyrus demonstrates patchy enhancement and a lesion in the right corona radiata demonstrates open ring enhancement directed away from the ventricle. There is no evidence of intracranial hemorrhage, mass, or acute infarct. 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.Cervical Spine: There are subcentimeter T2 hyperintense lesions within the spinal cord involving the bilateral dorsal columns at C3-4 and in the left hemicord at C6. There is straightening of the cervical spine alignment in the sagittal plane, but no spondylolisthesis. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is unremarkable. There is no significant spinal canal stenosis. The paravertebral soft tissues are unremarkable.
1. Multiple intracranial white matter lesions are compatible with demyelinating disease, such as multiple sclerosis, with signs of active inflammation is a few lesions.2. Lesions in the cervical spinal cord are also compatible ith demyelinating disease, such as multiple sclerosis.