81-year-old female status post fall; evaluate for fracture/dislocation BRAIN:There is no evidence of acute intracranial hemorrhage, mass or edema. Several bilateral lacunar infarctions in the basal ganglia. Multiple nonspecific foci of attenuation are seen in the periventricular and subcortical white matter which may represent small vessel ischemic disease, appearing similar to the previous MRI.Ventriculomegaly out of portion with age-related volume loss and may represent normal pressure hydrocephalus, unchanged. Prominence of the cortical sulci consistent with age-related volume loss. Atherosclerotic calcifications are seen in the internal carotid arteries, most prominently at the carotid bifurcations.The calvaria and skull base are radiographically normal without evidence of depressed skull fracture. The visualized paranasal sinuses and mastoid air cells are normally pneumatized.CERVICAL SPINE:There is reversal of the normal cervical lordosis with grade 1-2 anterolisthesis of C3 on C4. There is also grade 1 retrolisthesis of C4 on C5 and of C5 on C6. The vertebral body heights are grossly maintained. Prevertebral soft tissues are grossly unremarkable.Multilevel extensive degenerative changes are seen throughout the cervical spine with uncal vertebral joint hypertrophy, osteophyte formation, disk space narrowing, and neuroforamina narrowing. If high clinical concern for cord or ligamentous injury, MRI may be obtained for further evaluation.
1. No acute intracranial hemorrhage. No evidence of acute fracture.2. Stable ventriculomegaly. 3. Bilateral lacunar infarcts and likely small vessel ischemic disease of indeterminate age, appearing similar to the previous exam.4. Reversal of normal cervical lordosis extensive multilevel degenerative changes. If high clinical concern for spinal cord or ligamentous injury, MRI may be obtained for further evaluation.