 Brain: There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma appears unremarkable. 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 skull, paranasal sinuses, and scalp soft tissues are unremarkable.Lumbar Spine: There is diffuse thickening of most of the cauda equina nerve roots, generally to a mild degree. Otherwise, the imaged spinal cord displays normal signal and morphology. The vertebral column alignment is within normal limits. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is unremarkable. At L3-4, there is mild facet hypertrophy and ligamentum flavum thickening, without no significant spinal canal stenosis, but mild bilateral neural foramen narrowing. At L4-5, there is a based disc bulge with mild bilateral neural foramen narrowing, but no significant spinal canal. At L5-S1, there is disc desiccation and small central disc protrusion with no significant neural foramen or spinal canal stenosis. There paraspinal soft tissues are unremarkable.
1. No evidence of acute cerebral infarction, intracranial mass, or intracranial hemorrhage.2. Diffuse thickening of the cauda equina nerve roots. Differential include an inflammatory or neoplastic process, or perhaps a hereditary motor sensory neuropathy. Further evaluation via MRI with contrast and DRIVE/FIESTA sequence may be useful. 3. Mild degenerative spondylosis of the lumbar spine with small central disc protrusion at the L5-S1 level, but no significant spinal canal stenosis.