History of stroke now presenting with left-sided hyperreflexia. Motion artifact mildly degrades the postcontrast images.Brain:Scattered small foci of increased T2 signal in the periventricular and subcortical white matter compatible with chronic small vessel ischemic disease. No acute ischemia. No abnormal enhancement is identified postcontrast images.There is no evidence of intracranial hemorrhage, mass or edema. The ventricles and basal cisterns are normal in size and configuration. The expected intracranial vascular flow voids are present. The paranasal sinuses are clear. The visualized mastoid air cells are clear. The orbits are unremarkable.Cervical spine:There is mild loss of vertebral body height involving multiple cervical vertebrae most notably at the C5 level where there is mild wedging deformity. Heterogeneous marrow signal is nonspecific and at least in part related to reactive endplate marrow changes. There is exaggeration of the cervical lordosis at C6-7 associated with minimal retrolisthesis of C6 on C7. There is loss of intervertebral disc signal throughout the visualized cervical spine compatible with desiccation. There is marked loss of intervertebral disc height from C4 to C6 and T2-T4. The visualized spinal cord is normal in signal and morphology throughout.Level by level findings are as follows:C2-C3: Mild disc osteophyte complex and hypertrophy of the ligamentum flavum. No significant spinal canal or neural foraminal narrowing.C3-C4: No disc bulge. Uncovertebral hypertrophy creates minimal right neural foraminal stenosis. No significant spinal canal or left neural foraminal stenosis.C4-C5: Small disc osteophyte complex. Minimal left neural foraminal narrowing. No significant spinal canal stenosis or right neuroforaminal narrowing.C5-C6: Small disc osteophyte complex and hypertrophy of the ligamentum flavum create minimal spinal canal stenosis. Moderate right and mild left neural foraminal stenosis.C6-C7: Moderate central disc osteophyte complex and prominent hypertrophy of the ligamentum flavum create a moderate spinal canal stenosis. Moderate to severe left neural foraminal stenosis. Mild right neural foraminal stenosis.C7-T1: No disc bulge, spinal canal stenosis, or neuroforaminal narrowing.
1. Mild chronic small vessel ischemic changes in the brain.2. Multilevel spondylitic changes in the cervical spine which are most severe at C6-7 where there is moderate spinal canal stenosis and moderate to severe left neural foraminal stenosis.