There are different forms of lesions and they can ebb and flow, kind of like clouds, more than likely you should have a follow up MRI sooner rather than later. Things other than MS can also cause lesions, infections etc. Where you get the MRI also matters, was it at the same place? It looks like your diagnosis changed from RRMS to PPMS, if that is correct it is possible to see an increase in lesions. It also looks like you are on Ocrevus, which is a great therapy. The biggest concern is whey they use terms like black hole, which usually means the damage is more than likely permanent, good luck with things.

I think lesions do different things, and maybe just notice any further complications. I don't even know how many lesions I have. I don't think I even care, because I know how my body works or doesn't work. I think you shouldn't focus on how many lesions you have. Just carry on living your best life. My neurologist recently told me that my brain is shrinking. Everybody's brain is shrinking. It's called getting older. When you say you experience disequilibrium, do you mean you are dizzy or have vertigo? Stay strong!

2 years is kind of a big gap for an mri, but that may be due to ins reasons. What dmts are you on?