Presentation
Parathesia of both upper limbs and persistent headache
Patient Data
A few plaques of high FLAIR signal are seen in the right frontal lobe, the left parietal lobe, and the anterior part of the left temporal lobe. Some of these plaques are subcortical, while others are juxtacortical in distribution, involving the subcortical U fibers. No areas of diffusion restriction are seen in the diffusion-weighted study or areas of abnormal enhancement in the post-contrast study.
A focal region of high T2 signal is seen within the substance of the cervical cord opposite C4. It displays a high signal in T2 and STIR images. In the post-contrast study, it shows a faint enhancement. The plaque extends for a short segment and shows a peripheral wedge-shaped distribution.
Case Discussion
Multiple sclerosis (MS) is the most common demyelinating white matter disease. This patient was diagnosed with MS based on the radiological findings seen in the MRI of the brain and cervical spine.
The plaques seen in the brain and cord show the characteristic distribution of MS lesions and fulfill McDonald criteria for dissemination in time and space.
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