Multiple sclerosis: advanced

Case contributed by Henry Knipe
Diagnosis certain

Presentation

Leg weakness. No previous imaging available for comparison.

Patient Data

Age: 42
Gender: Female
mri

Multi-focal areas of infra- and supra-tentorial high T2/FLAIR signal predominantly within the supratentorial white matter, with characteristic Dawson's fingers. Further high T2/FLAIR signal foci are noted with the splenium of the corpus callosum, left midbrain, left cerebellar hemisphere. There are juxta-cortical lesions in the left parietal and occipital lobes. A few lesions demonstrated restricted diffusion in the left parietal lobe and right periventricular white matter.

Generalized cerebral atrophy, thinning of the corpus callosum and ventriculomegaly.

No intra or extra-axial collection, mass or areas of susceptibility artefact.

Conclusion:

Extensive high T2/FLAIR changes and volume loss in keeping with advanced of multiple sclerosis.

Case Discussion

The patient has a known history of multiple sclerosis. 

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