Female, 67 years old, with progressive loss of right hand function. History of breast cancer. Brain:No evidence of restricted diffusion, edema, mass effect or pathologic enhancement is seen. There are numerous scattered small foci of T2 hyperintensity in the cerebral white matter. A focus of susceptibility is present in the left frontal lobe which may represent a prior hemorrhagic event. No acute hemorrhage or abnormal extra-axial fluid is seen. The ventricles are normal in size and morphology.C-spine:The cervical lordosis is straightened. Vertebral body heights are preserved. No marrow replacement or edema is seen. Bulky ossification of the posterior longitudinal ligament (OPLL) is seen from C2-3 through C6-7. This results in severe cord impingement which is discussed more fully below. Patchy cord signal abnormality is seen at several levels. No epidural collections are present. No pathologic enhancement is seen. C2-3: OPLL superimposed on disc osteophyte formation. Minimal cord impingement. Minimal cord signal abnormality. Moderate foraminal narrowing.C3-4: OPLL with impingement of the central cord. Right sided cord signal abnormality. Moderate left and mild right foraminal narrowing. C4-5: OPLL with right paracentral focality causing severe cord impingement and marked cord signal abnormality. Mild left foraminal narrowing. Left facet arthropathy. C5-6: OPLL with central focality causing severe cord impingement and predominantly left sided cord signal abnormality. Moderate left and mild right foraminal narrowing. Left facet arthropathy. C6-7: OPLL and mild disc osteophyte formation. Mild central cord impingement. Mild left foraminal narrowing. Left facet arthropathy. C7-T1: No spinal canal stenosis or neuroforaminal narrowing.
1.Ossification of the posterior longitudinal ligament is seen through much of the cervical spine. This results in severe cord impingement at several levels, with cord signal abnormality which may represent a combination of edema and/or myelomalacia.2.No acute intracranial abnormalities. Findings which may reflect chronic microvascular disease. 