65 years Male (DOB: 10/3/1950)Reason: evaluate for causes of right paresthesia and weakness History: right paresthesia and weaknessPROVIDER NAME: PELEG M HOROWITZ EDWIN RAMOS MRA brain:Antegrade flow is present in the distal internal carotid arteries, the distal vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries.There is no evidence for intracranial aneurysm or cerebrovascular occlusion. The right vertebral artery is larger than on the left vertebral artery.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. No abnormal lesions are identified in the cervical spine.At C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there is no significant compromise to the spinal canal or neural foramina.At C4-5 there is a small disc bulge associated with uncovertebral osteophytes bilaterally at this level and some mild narrowing of the neural foramina. There is partial effacement of spinal fluid ventral and posterior the spinal cord at this level. There is narrowing of the neural foramina bilaterally with some mild encroachment of the exiting nerve roots bilaterally. This encroachment appears to be worse on the right when compared to the left side at this level. Overall there is a mild to moderate degree of spinal stenosis at this level.At C5-6 there is loss of disc space height, disc desiccation, disc bulge and endplate and uncovertebral osteophytes associated with effacement of spinal fluid ventral and posterior the spinal cord and mild to moderate degree of spinal stenosis. There is narrowing of the neural foramina bilaterally due to uncovertebral osteophytes at this level associated with encroachment of the left-sided exiting nerve roots.At C6-7 there is no significant compromise to spinal canal or neural foramina. There is a disc bulge present at this level associated with the small uncovertebral osteophytes and mild narrowing of the neural foramina.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact.Thoracic spine:The thoracic vertebral bodies are appropriate in the overall alignment and height. The thoracic spinal cord has normal signal characteristics and overall morphology. There is no compromise of thoracic spinal canal or exiting nerve roots. No abnormal lesions are identified in the thoracic spine.
1.There are degenerative changes present in the cervical spine worse at C4-5 and C5-6 where there is encroachment of right-sided exiting nerve roots at C4-5 and left-sided exiting nerve roots at C5-6 and mild to moderate spinal stenosis at these levels.2.There is no compromise to the thoracic spinal canal.3.No spinal cord lesions are identified.4.There is no evidence for intracranial cerebrovascular occlusive disease.