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Multiple sclerosis

Case contributed by Anthony Nuñez
Diagnosis almost certain


Paresthesias bilaterally in the upper limbs.

Patient Data

Age: 30 years
Gender: Male

MRI brain


High signal ovoid lesions perpendicular to the ventricles in FLAIR sequence in the periventricular white matter (i.e. Dawson's fingers), as well as confluent high signal lesions that compromises the callososeptal interface. Juxtacortical high signal lesions at the convexity in the frontal lobe. Multiple high signal lesions in brainstem and cerebellum. No brain atrophy.

Unfortunately a contrast-enhanced study is not available.

MRI cervical spine


Multiple lesions in the cervical spinal cord of less than two vertebral segments in length with a peripheral localization.

Unfortunately a contrast-enhanced study is not available.

Case Discussion

These are typical radiographic findings of multiple sclerosis in a young adult. 

The distribution pattern of lesions is essential in making this diagnosis, and it is always helpful to incorporate the sagittal FLAIR sequence in the study of a patient with suspicion of a demyelinating disease in order to asses the callososeptal interface.

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