scan of the brain was performed with this department's demyelination protocol.
On T2 and FLAIR weighted sequences, 19 small foci of abnornnal hyperintensity are identffied
subcortical white matter and periventricular deep white matter in the right and left frontal lobes, right and
left parietal lobes, and posterior right temporal lobe. The largest white matter lesion measures 6.3 mm in
maximal diameter. All are confined to white matter. None are associated with mass etiect or with
restricted diffusion. Normal signal intensity is preserved throughout gray and white matter m the occ\p'Aa\
tobes, brain stem, basal ganglia, corpus callosum and cerebellum.
No abnormal masses or mass effect are detected. The ventricles, cisterns, and sulci are appropriate \n
size and appearance for this patient's age.
fmpression: An intermediate number of small^foci of white matter demyeVination in bo\.h cerebTa\
hemispheres represent a nonspecific finding. The differential diagnosis woutd include postisc'rtemte
etiotog'ies, such as, microangiopathy or microemboli, post infectious or inflammatory et\o\og\es, such as,
acute "disseminated encephalomyelitis, primary demyelinating diseases, such as, multiple scleroses,
exposure to extrinsic agents, such as, chemotherapeutic agents which can produce dem^e\ina^on, and
prevfous'trauma. CorreTatJon'with clinical history and findings would be required to navroMv the dfflerential
diagnosis if possible.
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