Imaging & Reports

Purpose of This Section

This section provides a centralized reference to key imaging studies and diagnostic reports, summarized factually to support independent clinical review. Imaging summaries do not replace evaluation of original reports or images.

Neuroimaging

Brain MRI (Serial Studies, With and Without Contrast)

  • Periventricular and subcortical white matter hyperintensities consistent with demyelinating disease

  • Interval progression of lesion burden across serial studies

  • No consistent evidence of active demyelination on recent imaging

  • Stable left middle cranial fossa meningioma, under radiographic surveillance

  • Stable punctate focus of enhancement in the right Meckel’s cave, likely representing a tiny schwannoma or meningioma, under surveillance

  • No mass effect, midline shift, or acute intracranial abnormality identified

These intracranial findings are anatomically distinct from the pituitary macroadenoma and are monitored independently.

Spinal Imaging

Cervical Spine MRI

  • Postsurgical changes from C5–C7 anterior cervical discectomy and fusion

  • Multilevel disc bulging and spondylotic changes

  • Mild to moderate thecal sac and foraminal narrowing at select levels

  • No convincing demyelinating lesions identified within the cervical spinal cord

Thoracic Spine MRI

  • Mild multilevel degenerative changes

  • No abnormal cord signal or enhancement

Lumbar Spine MRI

  • Mild degenerative disc disease, most notable at L5–S1

  • Mild facet arthropathy

  • No significant spinal canal stenosis or nerve root compression

  • Incidental benign intraosseous hemangioma identified

Endocrine Imaging

Pituitary MRI

  • Preoperative imaging demonstrated pituitary macroadenoma with growth hormone excess

  • Postoperative imaging confirmed successful resection

  • No evidence of recurrent pituitary mass on follow-up studies

Cardiovascular and Autonomic Testing

Transthoracic Echocardiogram

  • Normal cardiac structure and systolic function

  • Normal left ventricular ejection fraction

  • No significant valvular disease

Tilt-Table Testing

  • Mild transient blood pressure changes during upright positioning

  • Symptoms reproduced without arrhythmia

  • Findings not diagnostic for classic neurocardiogenic syncope

Imaging Summary

Across studies, imaging demonstrates:

  • Objective evidence of central nervous system demyelination with progression over time

  • Multiple stable intracranial lesions under surveillance

  • Structural spinal disease without clear cord-level demyelination

  • Endocrine pathology successfully addressed surgically

Correlation between imaging findings and clinical symptom burden remains an area of ongoing review.