 Brain MRI: The presence of braces cause significant artifact anteriorly.The ventricles and sulci are normal in size. The cerebellar tonsils are in normal position. There are no masses, mass effect or midline shift. The pituitary gland is normal in size. There is no evidence for intracranial hemorrhage or acute cerebral, brainstem or cerebellar infarction. No diffusion-weighted abnormalities are identified. There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. The paranasal sinuses and mastoid air cells are clear. There is no abnormal enhancement within the brain. Sagittally acquired CSF flow demonstrates normal biphasic both anteriorly and posteriorly, maintained at the level of the foramen magnum and cerebellar tonsils.Complete spine MRI:Subtle enhancement is noted along the anterior surface of the distal conus involving the adjacent anterior nerve roots with questionable nerve root thickening.Numbering the complete spine beginning at C2 and progressing inferiorly demonstrates there is transitional anatomy with lumbarization of S1 resulting in a rudimentary S1/2 disc.There are no osseous dysplasias. There are no fractures or subluxations. The marrow signal is benign. The spinal cord and conus are normal in signal and morphology. The conus terminates at L2. There is no fatty filum. There are no findings of tethered cord. The visualized intra-abdominal and paraspinal contents are unremarkable.Slight reversal cervical curvature accentuates disc bulges within the cervical spine without morphologic abnormality of protrusion.Mild disc bulges are noted at T11/12 and T12/L1 without morphologic abnormality of protrusion.A Schmorl's node is present involving the superior endplate of L1.Abnormality within the spinal CSF spaces is felt to be secondary to CSF flow artifact and not AVM.There are no stenoses throughout the spine.Upon prone positioning, the conus and proximal cauda translate anteriorly.
1.The presence of braces cause significant artifact anteriorly. Given this caveat, negative MRI of the brain including gadolinium enhancement.2.Subtle enhancement is noted along the anterior surface of the distal conus involving the adjacent anterior nerve roots with questionable nerve root thickening. This is nonspecific and may be secondary to infectious or inflammatory etiologies. Given a negative contrast enhanced study of the remaining neuraxis, neoplastic etiologies are felt to be less likely.3.Abnormality within the spinal CSF spaces is felt to be secondary to CSF flow artifact and not AVM.4.No MRI evidence of Chiari malformation, fatty filum, or tethered cord.5.There are no stenoses throughout the spine.6.Findings were discussed with Dr. Frim on 3/23/2015 approximately 4:45 p.m.