Clinical question: Pontobulbar hyperintensity in evaluation. Signs and symptoms: Cerebellar ataxia. Pre and post enhanced cervical MRI:There is normal signal intensity and caliber of the cervical and uppermost visualized thoracic cord and without abnormal enhancement. There is normal anatomical alignment of the cervical spine, mild reversal of cervical lordosis which could be positional or due to pain/spasm.The signal intensity of the vertebral column is unremarkable and without abnormal enhancement.Foramen magnum is unremarkable.C2-C3 is unremarkable.C3-C4 demonstrate mild degenerative disease, small central shallow disc protrusion with expected subtle enhancement and without spinal stenosis. There is mild right neural foraminal compromise secondary to right uncovertebral hypertrophic spur.C4-C5 demonstrate mild degenerative disease without spinal stenosis or neural foraminal compromise.C5-C6 demonstrate mild disc disease and loss of disc height, there is a shallow central disc protrusion with expected enhancement and with resultant partial effacement of ventral subarachnoid space, subtle flattening deformity of the cord without spinal stenosis or neural foraminal compromise.C6-C7 demonstrate mild degenerative changes and unremarkable otherwise.C7-T1 is unremarkable.Incidental note is made of partially visualized foci of T2 hyperintensity in the anterior medulla as reported on prior brain MRI study
1.Normal signal intensity and caliber of cervical and upper most visualized thoracic cord without abnormal enhancement.2.Mild degenerative changes of cervical spine, small central disc protrusions with expected enhancement at C3-C4 and C5-C6 levels without spinal stenosis or neural foraminal compromise at any level. Normal anatomic alignment of the vertebral column however with mild reversal of cervical diagnosis which could be positional or secondary to pain/spasm.