Presentation
Intermittent vertigo
Patient Data
The white matter demyelination plaques are seen bilaterally deep white matter, juxta cortical, particularly in a periventricular distribution with perpendicular orientation (Dawson's fingers). They display a high signal on T2 and FLAIR, a low signal on T1. The high signal on DWI is believed to be a T2 shine-through effect as there is no evidence of restriction on the ADC map. The lesion in the right temporal lobe demonstrates subtle enhancement, which suggests current/recent activity.
Case Discussion
MRI findings are in keeping with multiple sclerosis.
Multiple sclerosis is a common demyelinating disease of the central nervous system. The diagnosis is mainly radiological and depends on detecting white matter lesions that disseminate in time and space.