Multiple sclerosis

Case contributed by Safwat Mohammad Almoghazy
Diagnosis certain

Presentation

A known case of multiple sclerosis under follow-up.

Patient Data

Age: 35 years
Gender: Female
mri

A multiple subcortical and deep white matter plaques at periventricular region ( giving Dawson fingers appearance )  and corpus callosum displaying hyperintense T2 and FLAIR signal intensity with no evidence of contrast enhancement.

A solitary lesion in the juxtacortical region in the left high parietal region displaying hyperintense signal in T2 & FLAIR sequences and hypointense signal in T1 with predominantly marginal post contrast enhancement suggestive of active plague for clinical correlation.

Mild involutional changes are seen in the brain parenchyma in the form of prominent cortical sulci and widened CSF spaces for age 

Case Discussion

A follow up known case of MS showing;

A solitary new enhancing lesion is seen in juxtacortical left parietal region showing marginal post contrast enhancement - likely active plaque.

The rest of the plaques in the brain and spinal cord are slightly less prominent in size with no contrast uptake.

The previously noted intramedullary plaques noted at the level of C2/C3  appear slightly less prominent in the current study with no evidence of post contrast enhancement.

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