Neck tightness and left side pulsatile tinnitus. Brain MRI: There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma and pituitary gland appear unremarkable. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. However, there appears to be subcentimeter protrusion of CSF into the right cavernous sinus. There is no midline shift or herniation. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.Brain MRA: There is no evidence of significant steno-occlusive lesions. There is minimal outpouching at the origin of the left superior cerebellar artery.Cervical Spine MRI: There is a posterior disc-osteophyte complex at C5-6 that indents the spinal cord and results in bilateral moderate neural foramen narrowing. There are also posterior disc-osteophyte complexes at C4-5 and C6-7 without significant spinal canal stenosis. There is perhaps mildly increased T2 signal within the spinal cord at this level versus artifact. The vertebral column alignment is within normal limits. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is unremarkable. The paravertebral soft tissues are unremarkable.
1. No evidence of intracranial mass lesions.2. A posterior disc-osteophyte complex at C5-6 indents the spinal cord and results in bilateral moderate neural foramen narrowing at this level, as well as possible signal abnormality within the spinal cord at this level versus artifact. Posterior disc-osteophyte complexes are also present at C4-5 and C6-7, but without significant spinal canal stenosis. 3. Minimal outpouching at the origin of the left superior cerebellar artery likely represents a prominent infundibulum rather than a true saccular aneurysm. Otherwise, no evidence of significant intracranial steno-occlusive lesions or vascular malformations within the limits of MRA.