Reason: MS, f/u progression History: paresthesias The CSF spaces are appropriate for the patient's stated age with no midline shift. There is redemonstration of a moderate degree of periventricular and subcortical white matter lesions which are hyperintense on T2 and flair MRI. Many of these are perpendicularly oriented to the lateral ventricles. Compared to the previous exam the patient has developed a couple new lesions. For example, there is one at the subcortical white matter of the right inferior parietal lobule which is new. There is another one in the right periventricular white matter at the posterior aspect of the body of the right lateral ventricle which is new. A lesion in the left frontal lobe subcortical white matter is smaller on the current examNormal 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.
Since the previous exam the patient has accumulated a few more periventricular white matter lesions