Concern for brain and spine abscess. Exam is limited by motion artifact.MRI brain: There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is mild scattered white matter T2 hyperintensity. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.MRI of the cervical spine: There is extensive abnormal signal and enhancement involving the C3 and C4 vertebral bodies and disc space with extension into the anterior epidural space, with narrowing of the spinal canal. There is extensive inflammatory changes and enhancement of prevertebral soft tissue and paraspinal musculature. There is loss of the usual cervical lordosis, but no subluxation. The vertebral body heights are maintained. There are secretions within the trachea. MRI of the thoracic spine: 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 spinal cord displays normal signal and morphology. The paravertebral soft tissues are unremarkable. There is right pleural fluid.
No evidence of intracranial abscess.Findings compatible with discitis-osteomyelitis involving C3 and C4 with extension of inflammatory changes in to the anterior epidural space and prevertebral space, but no abscess. 3. Secretions within the trachea may be a risk factor for aspiration pneumonia. Findings discussed with Dr. Sarah Tarplin at 11 AM on 2/20/2016.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.