Reason: stenosis History: RUE paresthesias. MRI brain:There is no evidence of intracranial hemorrhage, mass, or acute infarct. There are a few scattered subcortical T2 hyperintensities within the parietal lobes bilaterally. There is no abnormal intracranial enhancement. 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 orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.MRI cervical spine:There is straightening of the cervical spine, otherwise alignment is anatomic. Multilevel disc desiccation with mild disc space loss at C4-C5, C5-C6 and C6-C7. No abnormal marrow signal. There is increased signal within the posterior cord at C5-C6 extending approximately one vertebral level. Diffuse mild increased signal at C4-C5 adjacent to a disc osteophyte complex more likely likely represents myelomalacia or artifact. C2-C3: No significant spinal or neuroforaminal stenosis. C3-C4: No significant spinal or neuroforaminal stenosis. C4-C5: Mild posterior disc osteophyte complex, asymmetric to the left. No significant central canal stenosis. Minimal left neural foraminal stenosis. No right neural foraminal stenosis C5-C6: Minimal posterior disc osteophyte complex. No significant spinal or neuroforaminal stenosis. C6-C7: No significant spinal or neuroforaminal stenosis. C7-T1: No significant spinal or neuroforaminal stenosis.
1.Increased nonenhancing solitary focus of increased T2 signal within the posterior spinal cord at C5-C6 is nonspecific. Differential considerations include demyelinating disease and inflammatory etiologies with neoplasm considered unlikely.2.A few subcortical T2 hyperintensities are nonspecific and may represent mild chronic small vessel ischemic disease. Given lesional location and morphology, demyelination is less likely.