Disturbance of skin sensation [782.0], Reason for Study: ^Reason: Please evaluate for infarct or cerebral inflammation or vasculitis History: Worsening headache, new left arm paresthesia and numbness, chronic diffuse joint pains with high ANA Brain MRINo evidence of acute ischemic or hemorrhagic lesion.The ventricles, sulci and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia, or abnormal contrast enhancement. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.About 5.6mm tonsilar herniation through the foramen magnum.Brain MRA3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate normal ICAs, MCAs and ACAs. Vertebrobasilar system appears to be normal. No aneurysm. No arterial luminal stenosis.C-Spine MRINormal cervical lordosis has been lost. However, the cervical spine alignment is anatomic. The vertebral body height is preserved. The bone marrow and end plates demonstrate a normal MR appearance. The signal of the visualized cord is normal. The epidural space, thecal sac, and spinal cord are preserved with no evidence of spinal canal/neural foraminal narrowing or myelopathy. The intervertebral discs demonstrate normal T2 intensity and height with no evidence of disc herniation. The paraspinal soft tissues are unremarkable. There is no abnormal enhancement.
1. No evidence of acute ischemic or hemorrhagic lesion.2. 5.6mm tonsilar herniation through foramen magnum indicating possible Chiari malformation.3. Normal brain MRA4. Straightened cervical spine, otherwise unremarkable. 