Other malaise and fatigueClinical question: ischemic CVASigns and Symptoms: left-sided weakness x 3 days MRI brain:The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.MRI cervical spine:The cervical vertebral bodies are appropriate in overall alignment and height. The cervical spinal cord has normal signal characteristics and overall morphology. The cervical spinal canal is small. There is multilevel disc desiccation present.At C2-3 there is no significant compromise to the spinal canal or neural foramina. There is a mild disc bulge present at this levelAt C3-4 there is no significant compromise to the neural foramina. There is a mild disc bulge present at this level and partial effacement of spinal fluid ventral and posterior the spinal cord. Overall there is a mild degree of spinal stenosis presentAt C4-5 there is no significant compromise to the neural foramina. There is a small central disc protrusion present at this level associated with mild posterior ligamentous hypertrophy and partial effacement of spinal fluid ventral and posterior the spinal cord. Overall there is a mild degree of spinal stenosis present at this level.At C5-6 there is no significant compromise to the neural foramina. There is a small central disc protrusion present at this level associated with mild posterior ligamentous hypertrophy and partial effacement of spinal fluid ventral and posterior the spinal cord. Overall there is a mild degree of spinal stenosis present at this level.At C6-7 there is no significant compromise to the spinal canal or neural foramina. There is a small central disc protrusion at this level.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact.
1.There are some degenerative changes present in the cervical spine superimposed on a small cervical spinal canal. There is only mild spinal stenosis present at multiple levels resulting predominantly from disc disease.2.There is no evidence for acute ischemic cerebral infarction3.Periventricular and subcortical white matter changes of a mild degree are nonspecific. At this age they are most likely vascular related. 4.Exam is mildly degraded due to some patient motion which may obscure more subtle abnormalities.