Findings:
No intra- or extra-axial mass lesion or collection is identified. The ventricles and sulcal spaces are within normal limits. The midline structures are normal with no midline shift.
A periventricular white matter lesion with partial diffusion restriction is seen adjacent to the left posterior horn. Further, smaller punctiform foci of subcortical white matter lesions are also seen in bilateral frontal white matter. No evidence of any white matter lesions involving the basal ganglia, the brain stem or the cerebellum.
The brain parenchyma is otherwise unremarkable.
The pituitary gland is normal.
The orbits, paranasal sinuses and mastoid air cells are clear.
No bony abnormality is seen. The craniocervical junction is normal.
Conclusion:
Periventricular white matter lesion adjacent to the left posterior horn, suspicious of demyelination. However, the McDonald diagnostic criteria for dissemination in time and space are not fulfilled. Clinical correlation and further evaluation with contrast-enhanced MRI of the whole neuraxis is advised.