NMO

Multifocal patchy and nodular confluent T2/FLAIR hyperintensities involving bilateral periventricular white matter , corpus callosum apparently perpendicular to the calloso septal interphase (Dawson finger appearance) associated with small patchy hyperintensities involving the midbrain, pons, medulla, middle cerebellar peduncles relatively confined around the third ventricle without restriction of diffusion or mass effect – represents demyelinating disease, likely Neuromyelitis optica (NMO) versus multiple sclerosis.

Differential considerations also include:- acute disseminated encephalomyelitis (ADEM)

No evidence of significant mass effect or mid line shift.