Left-sided weakness in arm and leg, progressive over one year. Brain: Brain parenchyma appears within normal limits. No findings to suggest ischemia, intracranial mass, or demyelinating disease. No evidence of mass effect, midline shift, or herniation. The ventricles are within normal limits in size and configuration. Major flow-voids are preserved. Sella and orbits are grossly within normal limits. Paranasal sinuses and mastoid cells are clear. Bone marrow signal and extracranial soft tissues are within normal limits. Cervical Spine: Craniovertebral junction appears within normal limits. The cervical vertebral bodies are appropriate height. There is loss of normal cervical lordosis. Alignment is otherwise maintained. Bone marrow signal is within normal limits. The cervical spinal cord has normal signal characteristics and overall morphology.Degenerative changes are seen in the cervical spine as described below:C2-3: No significant compromise to the spinal canal or neural foramina.C3-4: No significant compromise to the spinal canal or neural foramina.C4-5: There is mild disc bulge and bilateral uncovertebral hypertrophy. No significant spinal canal stenosis. There is mild left neural foraminal stenosis. No significant right neural foraminal narrowing. C5-6: There is mild disc bulge and bilateral uncovertebral hypertrophy. There is effacement of the ventral thecal sac and minimal impression on the ventral cord. No cord signal abnormality. There is minimal left neural foraminal narrowing. No significant right neural foraminal narrowing.C6-7: There is disc osteophyte complex with effacement of the ventral thecal sac and mild impression on the left ventral cord. There is mild right neural foraminal narrowing. No significant left neural foraminal narrowing.C7-T1: No significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits.
1. Noncontrast MRI of the brain appears within normal limits. 2. No cervical cord signal abnormality. There are degenerative changes at C4-C5, C5-C6, and C6-C7 with mild spinal canal stenosis at C5-C6 and C6-C7. There is also mild left C4-C5 and minimal left C5-C6 neural foraminal narrowing which may be affecting the left C5 and C6 nerve roots. No higher grade neural foraminal stenosis is appreciated.