 The ventricles and sulci are prominent, consistent with moderate-severe age-related volume loss. The basal cisterns remain patent. There is no midline shift or mass effect. There are scattered punctate foci and confluent areas of abnormal T2/FLAIR hyperintensity within the periventricular white matter, consistent with relatively mild chronic small vessel ischemic changes. There is additional focal and cephalization along the posterior right frontal lobe laterally. There is no pathological enhancement. There is no diffusion abnormality. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. There is minimal grade 1 anterolisthesis of C7 on T1 which appears degenerative in nature. The cervical spine is in otherwise normal overall alignment, although with mild reversal of the normal cervical lordosis. The vertebral body heights are well-maintained, while there is mild multilevel disc narrowing, although there is also moderate-severe disc narrowing with prominent endplate degenerative marrow changes at T1-T2. No worrisome focal marrow signal abnormality is appreciated. The spinal cord is diminutive in caliber, with focal T2 hyperintensity along the right lateral aspect of the cord at the upper C6 level as seen on 7/33 suggesting myelomalacia. There is prominent developmental narrowing of the cervical spinal canal due to shortened pedicles.At C2-C3, there is right-sided uncovertebral hypertrophy as well as left facet arthropathy. There is overall mild to moderate central spinal canal stenosis, with moderate left and minimal right foraminal narrowing.At C3-C4, there is a mild posterior osteophyte disc complex superimposed by a shallow central disc protrusion. There is overall moderate central spinal canal stenosis. There is moderate-severe right and moderate left foraminal narrowing and bilateral uncovertebral hypertrophy.At C4-C5, there is mild diffuse posterior osteophyte disk complex with moderate central spinal canal stenosis. Bilateral uncovertebral hypertrophy contributing to moderate bilateral foraminal narrowing. There is also ligamentum flavum thickening.At C5-C6, there is a diffuse posterior osteophyte disk complex with superimposed right paracentral disc protrusion. There is moderate-severe central spinal canal stenosis with bilateral ligamentum flavum thickening. There is resultant severe right greater than left foraminal narrowing.At C6-C7, there is mild diffuse posterior osteophyte disk complex with overall moderate central spinal canal stenosis. There is mild bilateral uncovertebral hypertrophy and prominent ligamentum flavum thickening. There is also mild to moderate bilateral foraminal narrowing.At C7-T1, there is minimal uncovering the disc with superimposed mild disc bulge. There is mild bilateral facet arthropathy and ligamentum flavum thickening, as well as moderate bilateral foraminal narrowing.At T1-T2, sagittal images suggest a diffuse posterior osteophyte disk complex which indents the ventral thecal sac and results in mild bilateral foraminal narrowing.There is trace fluid in bilateral mastoid air cells. Incidental note is made of a prominent lobulated area of fat signal intensity along the anterior aspect of the left parotid gland which may represent a lipoma.
1. No acute abnormality. Minimal chronic small vessel ischemic changes with small area of peripheral right frontal lobe encephalomalacia.2. Developmentally slender cervical spinal canal with superimposed moderate spondylosis, resulting in up to moderate-severe central spinal canal stenosis at C5-C6 with complete effacement of CSF within the thecal sac, as well as severe bilateral foraminal narrowing at this level.3. Focal area of myelomalacia along the right cord at the upper C6 level. Overall, the cord appears thinned in caliber, likely a chronic finding.3. Trace degenerative grade 1 anterolisthesis of C7 on T1.