45-year-old woman with history of slurred speech and lower extremity spasticity. There is no restricted diffusion to suggest acute ischemia. There is no intracranial hemorrhage. There is no intracranial mass or mass-effect. The ventricles are within normal limits in size and configuration. A few, punctate foci of susceptibility artifact are noted in the subcortical cerebral white matter, likely small foci of hemosiderin deposition or mineralization. There is no abnormal parenchymal or meningeal enhancement. The major flow-voids are preserved. The sella and orbits are grossly within normal limits. The paranasal sinuses and mastoid cells are clear. Bone marrow signal and extracranial soft tissues are within normal limits. CERVICAL SPINE
1.No intracranial findings to explain the patient's symptoms.2.Multilevel cervical degenerative disease, progressed from the prior examination. There is spinal canal stenosis and mild cord impingement at C4/C5 without evidence of edema or acute inflammation.3.Numerous borderline enlarged bilateral cervical lymph nodes. Correlation with clinical and laboratory findings is suggested.