Clinical question: Spasticity. Signs and symptoms: Spasticity. Pre and post enhanced brain MRI:Negative diffusion weighted series.Examination demonstrate normal signal intensity of brain parenchyma on all MRI sequences. Post enhanced images demonstrate no detectable abnormal enhancement of brain parenchyma or the leptomeninges.There is uniform slight prominence of cortical sulci for patient's stated age which could be within upper limits of normal. Unremarkable ventricular system, CSF spaces and brain myelination otherwise.There is normal visualization of signal void of major intracranial arterial branches.The signal intensity of intracranial venous sinuses is within normal and the normal pattern of enhancement.Unremarkable images through the orbits and including axial fat sat post enhanced series.Unremarkable calvarium, soft tissues of the scalp and without abnormal enhancement.Moderate size retention cyst in the right maxillary sinus and minute ethmoid sinus disease is noted.Pre- and post enhanced cervical MRI:Examination demonstrates unremarkable signal intensity of vertebral column and within normal anatomical alignment.There is mild degenerative disc disease throughout the cervical spine however without evidence of central spinal stenosis at any level.Degenerative changes however results in mild left neural foraminal compromise at C3-C4, moderate neural foraminal compromise on the right at C4-C5 moderate right and mild left neural foraminal compromise at C5-C6, mild neural foraminal compromise on the left at C6-C7.On post enhanced images there is no detectable abnormal enhancement of the cord, leptomeninges or the vertebral column.Pre- and post enhanced thoracic MRI:There is unremarkable signal intensity of vertebral column and within normal anatomical alignment.There is normal signal intensity and caliber of the thoracic cord.There is no evidence of spinal stenosis or definitive evidence of neural foraminal compromise at any level.There is no detectable abnormal enhancement of the vertebral column, thoracic cord or the leptomeninges.There is exaggerated left ligamentum flavum hypertrophy at T3 level with partial effacement of the dorsal subarachnoid space however without mass effect on the cord or central spinal stenosis.
1.Pre- and post enhanced brain MRI is unremarkable. Please see above comments.2.Pre-and post enhanced cervical MRI demonstrate mild degenerative changes without spinal stenosis however with neural foraminal compromise as detailed per level above. Normal signal intensity and caliber of cervical cord. No detectable abnormal enhancement of vertebral column, cord or the leptomeninges.3.Pre and post enhanced thoracic MRI demonstrate normal signal intensity and caliber of thoracic cord without abnormal enhancement. Mild degenerative changes without spinal stenosis or neural foraminal compromise at any level. No detectable abnormal enhancement of the vertebral column.