49 years Female (DOB:6/13/1967)Reason: patient with MS and cognitive decline - please assess MS burden (compare with 2003) History: language impairment and retrieval memoryPROVIDER/ATTENDING NAME: JAMES A. MASTRIANNI JAMES A. MASTRIANNI 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 as well as the left pons and middle cerebellar peduncle. There is FLAIR and T2 hyperintensity present in the gray matter adjacent to the right collateral sulcus. The trigones of the lateral ventricles are generous. These findings were present on the prior exam from 2003 but have not changed substantially. Please note however that the prior exam was somewhat compromised due to motion artifact.No abnormal 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.
1.Multiple periventricular, subcortical and subcortical white matter lesions are present in which appear to have been present on prior exam from 2003. There is not appear to be a significant change since that time to the extent of comparison possible.2.Mild ventriculomegaly is also stable.