No new lessons for the first time Results Report: HISTORY follow up post therapy start for MS COMPARISON 3/24/2025 TECHNIQUE MRI BRAIN WITH & W/O CONTRAST. FINDINGS Supratentorial: Consistent with the given history of multiple sclerosis, there are extensive periventricular, deep white matter and subcortical white matter T2 FLAIR signal hyperintensities. Periventricular lesions are perpendicular to the ventricles there are T1 black holes also noted scattered throughout the white matter. No definite active enhancing lesion. Infratentorial: Demyelinating lesions noted in the brainstem and cerebellar peduncles Ventricles/extra-axial spaces: Normal. Flow voids: Intact. Extracranial structures: Visualized paranasal sinuses and mastoid air cells are clear. No abnormalities of the visualized orbits or calvarium.No scalp soft tissue swelling. Electronically signed by: Kevin Welker, MD (December 03 2025 01:23 PM EST) Impression: Stable demyelination of the supratentorial and infratentorial brain. No definite new or active enhancing demyelination identified. BUXTON, TIMOTHY MICHAEL Date of birth: August 2, 1965 Report generated by My HealtheVet on VA.gov on December 9, 2025 Page 3 of 79