Diagnosis: Multiple sclerosisClinical question: MS, f/u progressionSigns and Symptoms: AtaxiaComments: MS Protocol. Please consult Dr. Jack Collins for this MS Protocol. No DTI | 3T MRI | MRI brain:There is a moderate degree of periventricular and to lesser degree subcortical white matter lesions present. These are hypointense on T1-weighted imaging. Many of these are perpendicularly oriented to the lateral ventricles. There is some involvement of the corpus callosum at the colossal-cingulate junction.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. There are patchy signal hyperintense lesions present in the cervical spinal cord. One lesion involves the left hemicord at the C6-7 disc space level. Another small one involves the right lateral aspect of the spinal cord at the C6 vertebral level . Another one involves the left hemicord at the C5 vertebral level and yet another involves the left hemicord at the C3 level. There is no associated cord enlargement and in general these are fairly small lesions based on size.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.At C4-5 there is no significant compromise to the spinal canal or neural foramina.At C5-6 there is no significant compromise to the spinal canal or neural foramina.At C6-7 there is no significant compromise to the spinal canal or neural foramina.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 are multiple brain parenchymal lesions present in the periventricular and subcortical white matter which are compatible with patient's clinical diagnosis of demyelinating disorder.2.There are multiple lesions in the spinal cord which are also compatible with demyelinating disorder.