 MRI brain:The CSF spaces are appropriate for the patient's stated age with no midline shift.Periventricular and subcortical white matter changes of a mild degree are nonspecific. At this age they are most likely vascular related.No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.MRI cervical spine:The cervical vertebral bodies are appropriate in overall alignment and height. The cervical spinal cord has normal signal characteristics and overall morphology. No abnormal enhancing lesions are identified in the cervical spine.At C2-3 there is no significant compromise to the spinal canal or neural foramina. There is a mild disc bulge, disc desiccation posterior ligamentous hypertrophy at this level.At C3-4 there is no significant compromise to the spinal canal. There is disc desiccation at this level associated with a mild disc bulge. There are bilateral uncovertebral osteophytes present but larger on the right versus the left side associated with encroachment of the neural foramina right worse than left. There is partial effacement of spinal fluid ventral and posterior the spinal cord at this level.At C4-5 there is disc desiccation and broad-based central disc extrusion associated with bilateral uncovertebral osteophytes and encroachment of the right sided exiting nerve roots. There is posterior ligamentous hypertrophy at this level. There is effacement of the spinal fluid ventral and posterior to the spinal cord at this level as well as mild flattening of the spinal cord. Overall there is a moderate degree of spinal stenosis at this level.At C5-6 there is a left paramedian disc extrusion present associated with effacement of spinal fluid ventral to the left hemicord. There are small uncovertebral osteophytes at this level associated with encroachment of the left-sided exiting nerve roots more than the right-sided exiting nerve roots. At C6-7 there is no significant compromise to the spinal canal or neural foramina.At C7-T1 there is loss of disc space height and some endplate reactive changes as well as right-sided uncovertebral osteophytes with some mild encroachment of right-sided exiting nerve roots.The vertebral artery flow voids appear to be intact.
1.There is a moderate degree of spinal stenosis present at C4-5 related to degenerative changes as described above. There is milder narrowing of the spinal canal at C3-4 and C5-6.2.There is multilevel neural foramen encroachment of exiting nerve roots due to degenerative changes as described above. This is worse on the right side at C3-4 but also present on the right side at C4-5 as well as the left-sided C5-6 and C6-7. There there is some narrowing of neural foramina at other levels as well.Periventricular and subcortical white matter changes of a mild degree are nonspecific. At this age they are most likely vascular related. 