Clinical question: Follow-up newly found ventricular mass. Signs and symptoms: Left eye vision loss. Pre and post cervical MRI:Examination demonstrate no evidence of abnormal enhancement of the vertebral column, cord or the leptomeninges to suggest malignancy/metastatic disease.Foramen magnum is unremarkable.C2-C3 demonstrate degenerative changes without spinal stenosis or neural foraminal compromise.C3-C4 demonstrate advanced disc disease and loss of disc height, mild facet and ligamentum flavum hypertrophic/degenerative changes. There is mild kyphotic deformity of cervical spine centered at this level secondary to degenerative changes. Constellation of findings results in flattening and posterior displacement of the cord (R>L) and moderate central spinal stenosis. Significant right and mild left neural foraminal compromise is also detected.C4-C5 demonstrate mild disc disease and degenerative changes of posterior elements without central spinal stenosis or neural foraminal compromise.C5-C6 demonstrate mild disc disease and loss of disc height and mild bilateral facet and ligamentum flavum hypertrophy. No central spinal stenosis however moderate left and mild right neural foraminal compromise is present.C6/C7 demonstrates mild disc disease and mild facet ligamentum flavum degenerative changes without spinal stenosis or neural foraminal compromise.C7-T1 is unremarkable.Incidental note is made of a prominent right lobe of thyroid which is poorly visualized on this exam and recommend follow-up with dedicated imaging. Incidental note as well is made of partially visualized postoperative changes of transsphenoidal hypophysectomy.Pre- and post enhanced thoracic MRI:The alignment of vertebral column is anatomical.The signal intensity of vertebral column is unremarkable.The signal intensity and caliber of the thoracic cord is within normal limits.There is no detectable abnormal enhancement of the vertebral column, thoracic cord or the leptomeninges.Mild degenerative changes of thoracic spine is noted however without evidence of spinal canal or neural foraminal compromise.Pre and post lumbar MRI:There is normal anatomical alignment and signal intensity of vertebral column without abnormal enhancement.The lower most visualized thoracic cord, conus and the cauda equina is unremarkable and without abnormal enhancement.T12-L1 is unremarkable exception of mild hypertrophic changes of posterior elements.L1-L2 is unremarkable with the exception of mild degenerative changes of posterior.L2-L3 demonstrate mild facet and ligamentum flavum hypertrophy and unremarkable otherwise.L3-L4 demonstrate mild to moderate ligamentum flavum hypertrophy and mild facet disease without spinal stenosis or neural foraminal compromise.L4-L5 demonstrate mild to moderate disc disease, loss of disc height, moderate left and mild right facet and ligamentum flavum hypertrophic changes. Examination of this level also demonstrates a broad-based disc protrusion extending from midline laterally with resultant moderate left lateral recess compromise and mild central spinal and left neural foraminal stenosis.L5-S1 demonstrate mild degenerative changes and unremarkable otherwise.Unremarkable visualized SI joints.Unremarkable. Spinal soft tissues.
1.Pre- and post enhanced MRI of cervical spine demonstrate no evidence of a mass or malignancy. Extensive degenerative changes at C3-C4 with resultant mild reversal of cervical lordosis and central spinal stenosis as detailed. Mild degenerative changes at other levels without central spinal stenosis. No detectable abnormal enhancement of the cord or the vertebral column and normal signal intensity and caliber of the cervical cord.2.Pre- and post enhanced MRI of thoracic spine is unremarkable other than mild degenerative changes. No detectable abnormal enhancement of the vertebral column, cord or the leptomeninges.3.Pre- and post enhanced lumbar MRI demonstrate no evidence of a mass or malignancy. Degenerative changes at L4/L5 and including a left sided disc protrusion resulting in mild central spinal stenosis, moderate left lateral recess compromise and left neural foraminal compromise as detailed above.4.Incidental note on this exam is made of a Tornwaldt cyst, partially visualized postoperative changes of transsphenoidal hypophysectomy and prominence of right lobe of thyroid which can be further assessed with dedicated imaging. 