Female, 25 years old, with paresthesias and headaches. Evaluate for demyelinating disease. Also with low back pain. Evaluate for spinal stenosis. Brain:Parenchymal morphology is within normal limits. No areas of focal signal abnormality, edema or mass effect are detected. No abnormal extra-axial collections are seen. Ventricles are normal in size and morphology. Non-expansile FLAIR hyperintense and T1 intermediate intensity material is evident within the left petrous apex.Lumbar:Alignment is anatomic. Vertebral body height and morphology are within normal limits. No marrow replacement or marrow edema is detected. The visualized distal spinal cord, conus and nerve roots of the cauda equina are within normal limits. No epidural abnormalities are suspected. The intervertebral discs are preserved. No significant compromise of the spinal canal or neural foramina is seen. Mild facet arthropathy develops at lower lumbar levels.
1.Unremarkable evaluation of the brain with no findings to suggest evaluating disease or any other specific abnormality.2.Asymmetric signal abnormally is seen within the left petrous apex. The absence of bony expansion favors this to represent trapped secretions in the petrous apex air cells rather than a more aggressive process. This is likely an incidental finding but correlation with the timing and laterally of the patient's headaches is suggested.3.Apart from mild facet arthropathy at lower lumbar levels, no specific lumbar spine abnormalities are identified.