 Brain: Exam is limited by metallic artifact from braces, especially of the orbits and paranasal sinuses. Within these limitations, there is no restricted diffusion to indicate an acute ischemic infarct. No susceptibility weighted abnormalities to indicate hemorrhage within the limitations caused by extensive artifact. There are no masses, mass effect or midline shift. Several subcortical punctate white matter signal hyperintensities on flair and T2 imaging, including within the left superior frontal gyrus, are stable. The ventricles and sulci are normal in size. There are no extraaxial fluid collections or subdural hematomas. The cerebellar tonsils are in normal position. The pituitary gland is normal in size. Flow voids are present within the major vessels indicating patency. The mastoid air cells are clear. There is no abnormal enhancement within the brain. Cervical Spine: There is slight reversal of lordosis of the cervical spine. There is a small left paracentral disc protrusion with resultant mild to moderate spinal canal narrowing at the C3/4 level. No neuroforaminal stenosis is noted in the cervical spine. The marrow signal is benign. The cervical and upper thoracic cord is normal in signal without abnormal enhancement. The cervicomedullary junction is normal. The visualized paraspinal contents are unremarkable.
1.Evaluation of the brain is limited secondary to extensive artifact from braces. Within these limitations, there are no acute brain abnormalities.2.No discrete evidence of demyelination in the brain or cervical spine.3.There is a small left paracentral disc protrusion with resultant mild to moderate spinal canal narrowing at the C3/4 level.