Dysphagia. Facial and uvula asymmetry. Also, exaggerated right bicep reflexes. Brain: There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma and pituitary gland appear unremarkable. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, and scalp soft tissues are grossly unremarkable. There is mild mucosal thickening in the paranasal sinuses. There are small retention cysts in the nasopharyngeal mucosa.Cervical spine: There is minimal retrolisthesis of C3 on C4 and C4 on C5. The vertebral bodies are preserved in height. There is mild degenerative marrow signal along the C6-C7 and to lesser extent C5-C6 endplates. There is also a subcentimeter probable hemangioma in the C3 vertebral body. At C3-C4, a disc-osteophyte complex and facet and uncovertebral arthropathy result in mild right neural foraminal narrowing. At C4-C5, there is mild spinal canal stenosis caused by a disc-osteophyte complex and mild-to-moderate left neuroforaminal stenosis caused by uncovertebral and facet arthropathy. At C5-C6, a disc-osteophyte complexes causes mild-to-moderate spinal canal stenosis and uncovertebral arthropathy results in mild-to-moderate bilateral neural foraminal stenosis. At C6-C7, there a small disc-osteophyte complex that results in mild spinal canal narrowing and mild right neural foraminal stenosis caused by uncovertebral arthropathy. The spinal cord displays normal signal. The paravertebral soft tissues are unremarkable.
1. No evidence of intracranial hemorrhage, mass, or acute infarct. Uvular asymmetry without a mass may have been present since 2006.2. Multilevel cervical spondylosis, with mild-to-moderate spinal canal and bilateral neural foraminal stenosis at C5-6.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.