Answer:
MULTIPLE SCLEROSIS
Findings:
MRI=MULTIPLE T1 INTENSITY AND T2 HYPER INTENSE LESION IN CALLOSOSEPTAL INTERFACE ,WHICH SHOWS DIFFUSION RESTRICTION,POST CONTRAST SHOWS INCOMPLETE RING ENHANCEMENT.
Discussion:
Demyelinating disorders are characterized by inflammation and selective destruction of central nervous system (CNS) myelin. The peripheral nervous system (PNS) is spared more common in women age of onset is typically between 20 and 40 years symptoms include Weakness of the limbs, Spasticity Optic neuritis (ON) ,Visual blurring ,Diplopia Sensory symptoms are varied and include both paresthesias (e.g., tingling, prickling sensations, formications, "pins and needles," or painful burning) and hypesthesia (e.g., reduced sensation, numbness, or a "dead" feeling). Bladder dysfunction IMAGING;Multiple perpendicular callososeptal T2 hyperintensities • Location > 85% periventricular/perivenous 50-90% callososeptal interface round, or ovoid; "bevelled","target", "lesion-in-a-lesion" appearance • Perivenular extension; "Dawson finger" • Transient enhancement during active demyelination TREATMENT;Glucocorticoids intravenous methylprednisolone are used to manage either first attacks or acute exacerbation.
Contributed By: Dr. Daniel Peter, PGY-3, B.I.R
MULTIPLE SCLEROSIS
Findings:
MRI=MULTIPLE T1 INTENSITY AND T2 HYPER INTENSE LESION IN CALLOSOSEPTAL INTERFACE ,WHICH SHOWS DIFFUSION RESTRICTION,POST CONTRAST SHOWS INCOMPLETE RING ENHANCEMENT.
Discussion:
Demyelinating disorders are characterized by inflammation and selective destruction of central nervous system (CNS) myelin. The peripheral nervous system (PNS) is spared more common in women age of onset is typically between 20 and 40 years symptoms include Weakness of the limbs, Spasticity Optic neuritis (ON) ,Visual blurring ,Diplopia Sensory symptoms are varied and include both paresthesias (e.g., tingling, prickling sensations, formications, "pins and needles," or painful burning) and hypesthesia (e.g., reduced sensation, numbness, or a "dead" feeling). Bladder dysfunction IMAGING;Multiple perpendicular callososeptal T2 hyperintensities • Location > 85% periventricular/perivenous 50-90% callososeptal interface round, or ovoid; "bevelled","target", "lesion-in-a-lesion" appearance • Perivenular extension; "Dawson finger" • Transient enhancement during active demyelination TREATMENT;Glucocorticoids intravenous methylprednisolone are used to manage either first attacks or acute exacerbation.
Contributed By: Dr. Daniel Peter, PGY-3, B.I.R