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Multiple sclerosis

Case contributed by Bruno Di Muzio
Diagnosis almost certain

Presentation

A teenager with multiple sensory and motor disturbances.

Patient Data

Age: 16 years
Gender: Female

MRI Brain (selected images)

mri

Multiple hyperintense foci scattered along the periventricular white matter, semi-oval centers, and subcortical areas. Lesions extending up through corpus callosum ("Dawson`s fingers"). Active lesion on the right shows incomplete enhancement (open ring sign).

MRI Cx spine

mri

Hyperintense foci are observed in the cord at the level of C5 as well as in the bulb.

Case Discussion

Multiple Sclerosis is a progressive disease in which inflammation and demyelination of white matter on central nervous system result in multiple neurological signs and symptoms. Even though this was her first MRI, the findings fulfill the McDonald criteria for MS on imaging with both dissemination in time and space demonstrated. 

  • space: periventricular, infratentorial, and spinal cord lesions have been demonstrated
  • time: simultaneous presence of a gadolinium-enhancing lesion and a non-enhancing T2-hyperintense lesion

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