Vomiting with a medullary lesion. There is an expansile, infiltrative, high T2 signal lesion with patchy enhancement involving the medulla and upper cervical spinal cord, which measures up to 48 mm in length and 18 mm in width. There is no evidence of other spinal cord lesions. The vertebral column alignment is within normal limits. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is unremarkable. There is no significant spinal canal stenosis. The paravertebral soft tissues are unremarkable. There is a small amount of fluid in the pelvis, which is likely physiological.
An infiltrative lesion involving the medulla and upper cervical spinal cord may represent a neoplasm, such as an astrocytoma, rather than an atypical demyelinating or inflammatory lesion.