Clinical question to be answered: Evaluate for epidural hematoma in an anticoagulated patient can't get an MRI. Signs and symptoms: Myelopathy. This examination was performed with contrast to evaluate for possible epidural process (abscess, hematoma). This examination is not the appropriate test and it may not visualize any of these abnormalities on this exam. This exam however was performed due to patient's inability to obtain an MRI. Advanced degenerative disk disease at C3 -- C4 and C4 and C5 levels are again identified. There is grade 1 retrolisthesis of C4 in respect to C5. There is reversal of cervical lordosis into kyphotic deformity centered at C3 -- C4 level.Axial and sagittal reformatted images demonstrate no definitive evidence of any abnormal enhancement within the epidural space in the cervical region from C2 through C7. Images below this level are even further obscured due to shoulder artifacts and nondiagnostic for any of the above clinical question concerns.Foramina magnum.Examination at this level is unremarkable.C2 -- C3. No central spinal stenosis or neural foramina compromise.C3 -- C4.Minimal compromise of bilateral neural foramina. Flattening and posterior displacement of the cord secondary to ventral hypertrophic changes. Borderline central spinal stenosis of 7.9-mm is suspected.C4 -- C5. Advanced degenerative disk disease and retrolisthesis. Central spinal stenosis of 6.6-mm is suspected. Compromise of bilateral neural foramina secondary to degenerative changes.C5 -- C6. Minimal degenerative changes. Suspected minimal left neural foramina compromise. No central spinal stenosis.C6 -- C7.No central spinal stenosis or neural foramina compromise.C7 -- T1.Examination at this level is unremarkable.100 cc of Omnipaque was utilized for the above study.
1.Extensive degenerative changes of cervical spine with multilevel neural foramina compromise and central spinal stenosis as detailed.2.Limited value examination for detection of epidural hematoma or abscess however no definitive finding to suggest either one of the above suspected clinical questions.A