36 years Female (DOB:4/28/1979)Reason: myoclonus History: action myoclonus, intubated X 7 days for statusPROVIDER/ATTENDING NAME: FERNANDO D GOLDENBERG THOMAS J KELLY MRI brain:There is mild dural enhancement and thickening adjacent to the right frontal and parietal lobes. There are a couple focal nonenhancing tubular lesions measuring which are dark on T2 imaging and bright on T1 weighted imaging. These are located adjacent to the dura but in the subarachnoid space and appear to adhere to the dura. One is located adjacent to the right frontal lobe and one is located adjacent to the right parietal lobe. There is some associated susceptibility effect with these lesions. Although suggests that this may represent subacute blood.There is a small developmental venous anomaly present along the left postcentral gyrus.The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.MRI cervical spine:The cervical vertebral bodies are appropriate in overall alignment and height. The cervical spinal cord has normal signal characteristics and overall morphology. No abnormal enhancing lesions are identified in the cervical spine. There is multilevel disc desiccation present.At C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there is no significant compromise to the spinal canal or neural foramina. There is a disc bulge present at this level associated with small uncovertebral osteophytes.At C4-5 there is no significant compromise to the spinal canal. There are bilateral uncovertebral osteophytes at this level associated with disc material. There is narrowing of the neural foramina with bilateral moderate encroachment of the exiting nerve roots.At C5-6 there is no significant compromise to the spinal canal. There are bilateral uncovertebral osteophytes at this level associated with disc material. There is narrowing of the neural foramina with mild encroachment of exiting nerve roots on the right and moderate encroachment of the exiting nerve roots on the left.At C6-7 there is no significant compromise to the spinal canal. There are bilateral uncovertebral osteophytes at this level associated with disc material. There is narrowing of the neural foramina with mild encroachment of exiting nerve roots on the right and moderate encroachment of the exiting nerve roots on the left.At C7-T1 there is no significant compromise to the spinal canal. There are bilateral uncovertebral osteophytes at this level associated with disc material. There is narrowing of the neural foramina with mild encroachment of exiting nerve roots on the left and moderate encroachment of the exiting nerve roots on the right.The vertebral artery flow voids appear to be intact.
1.There is some pachymeningeal thickening present on the right side which is a nonspecific finding. This could be reactive change to a separate pathology. Dural based on clock lesion may have a appearance like this but would be somewhat unusual.2.Adjacent to the pachymeningeal thickening there are tubular lesions. These could represent calcifications or cortical venous thrombi. A CT of the head and CT venogram may be helpful to sort this out.3.There are degenerative changes present in the cervical spine without compromise to the spinal cord. There is encroachment of exiting nerve roots bilaterally at C4-5, on the right at C6-7 and on the left at C5-6.