47 years Female (DOB: 5/3/1969)Reason: please do Dr. Javed MS protocol and compare to prior History: progression MS, paresthesias and fatiguePROVIDER NAME: JACQUELINE T. BERNARD JACQUELINE T. BERNARD MRI brain:The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images. These were also present on the prior exam. There is a new lesion present in the right parietal lobe subcortical white matter adjacent to an older lesion. It is associated with some ring-like contrast enhancement.No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.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. Within the spinal cord there is a signal hyperintense lesion redemonstrated at the C1 vertebral level centrally and posteriorly. This was also present on the prior exam. There is redemonstration of a right posterior lateral T2 signal hyperintense lesion at the C3 vertebral body level No abnormal enhancing lesions are identified in the cervical spine.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. There is a disc bulge present at this level.At C4-5 there is no significant compromise to the spinal canal or neural foramina. There is a disc bulge present at this level.At C5-6 there is no significant compromise to the spinal canal or neural foramina. There is a small left posterior lateral disc protrusion present this level.At C6-7 there is no significant compromise to the spinal canal or neural foramina. There is a disc bulge present this level.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact.
1.There is redemonstration of multiple lesions present in the periventricular subcortical white matter with the addition of a new lesion in the right parietal lobe subcortical white matter which appears to be in the subacute or acute stage.2.There is redemonstration of multiple white matter lesions in the cervical spinal cord which are stable compared to the prior exam.3.There are degenerative changes present cervical spine without significant compromise to spinal canal or neural foramina.