Seizures and chronic gait disturbance. Brain: There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is mild scattered cerebral white matter T2 hyperintensity. There is no abnormal intracranial enhancement. There is mild cerebral volume loss. 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 a mild left maxillary sinus mucosal thickening.Cervical Spine: There is multilevel degenerative spondylosis and posterior longitudinal ligament ossification that results in spinal cord compression from C3-4 to C4-5 and substantial bilateral neural foraminal stenosis at these levels. There is also high T2 signal and volume loss in the spinal cord at C4-5. The vertebral column alignment is within normal limits. The vertebral body heights are preserved. The vertebral bone marrow signal is unremarkable. The paravertebral soft tissues are unremarkable.
1. Mild scattered cerebral white matter T2 hyperintensity is non-specific, but may represent chronic small vessel ischemic disease. Otherwise, no evidence of intracranial hemorrhage, mass, or acute infarct. 2. Multilevel degenerative spondylosis and posterior longitudinal ligament ossification that results in spinal cord compression from C3-4 to C4-5 and substantial bilateral neural foraminal stenosis at these levels, as well as myelomalacia at C4-5. 