Female, 60 years old, with left-sided numbness and pain. Left hemibody sensory deficits to light touch and pain, sudden onset. Brain MRI:A band of T2 hyperintensity is seen traversing the pons. There is some associated diffusion hyperintensity but no ADC correlate to verify acute ischemia/cytotoxic edema. A few additional scattered small foci of T2 hyperintensity are seen through the cerebral hemispheres. No lesions of the thalami are seen. No edema or mass effect is detected. There are no findings to suggest acute intracranial hemorrhage or any abnormal extra-axial fluid collection. Ventricular size and morphology are within normal limits.Brain MRA:No evidence of significant vascular stenosis or occlusion is seen. No aneurysm or vascular malformation is suspected. The left intracranial vertebral artery is diminutive, but this can be a normal variant. The extracranial vertebral artery is better assessed on subsequent neck MRA. C-spine MRI:Alignment is anatomic. Vertebral body height and morphology are within normal limits. No pathologic marrow replacement is seen. There may be mild endplate edema at C7. The visualized spinal cord shows normal signal intensity and morphology. No epidural abnormalities are suspected.C2-3: No spinal canal stenosis or neuroforaminal narrowing. C3-4: Minimal posterior disc-osteophyte complex formation. No spinal canal or foraminal stenosis. C4-5: No spinal canal stenosis or neuroforaminal narrowing. C5-6: Posterior disc-osteophyte complex formation with slight effacement of the ventral thecal sac. No significant spinal canal stenosis. Mild right foraminal narrowing. C6-7: Minimal posterior disc-osteophyte complex formation. No spinal canal stenosis. No foraminal narrowing. C7-T1: Posterior disc-osteophyte complex formation. Slight effacement of ventral thecal sac. No significant spinal canal stenosis. Moderate bilateral foraminal narrowing.
1.No definite acute intracranial abnormality is seen. Signal abnormality in the pons is favored to be chronic and may reflect the sequelae of microvascular ischemia.2.Unremarkable MRA evaluation of the brain.3.Mild degenerative disease is seen in the cervical spine. No significant cord or nerve root impingement is seen. No abnormalities of the spinal cord are detected.