Clinical question: Evaluate for nerve root compression causing hyperreflexia. Signs and symptoms: Hypertension. Nonenhanced cervical MRI:There is normal anatomical alignment of the vertebral column however with a straightening of cervical lordosis. There is some a large focus of marrow signal change involving extensively the left aspect of T1 vertebrae and extending into the left pedicle and articulating facet. This finding demonstrates increased T2 signal intensity both on T1 and T2 weighted images and the appearance is highly suggestive of a benign hemangioma. Unremarkable signal intensity of vertebral column otherwise.Foramen magnum is unremarkable.C2 -- C3 demonstrate mild degenerative changes with resultant moderate bilateral neural foraminal compromise.C3 -- C4 demonstrate degenerative changes with resultant significant bilateral neural foraminal compromise and no central spinal stenosis.C4 -- C5 demonstrate degenerative changes with resultant significant (left greater than right) neural foraminal compromise and no central spinal stenosis.C5 -- C6 demonstrate degenerative changes with resultant significant bilateral neural foraminal compromise and no central spinal stenosis.C6 -- C7 demonstrate degenerative changes with resultant significant left and moderate right neural foraminal compromise without central spinal stenosis.C7 -- T1 demonstrate moderate (left greater than right) neuroforaminal compromise and no central spinal stenosis.T1 -- T2 there was a degenerative changes resulting in mild central spinal stenosis and moderate bilateral neuroforaminal compromise (right greater than left).The signal intensity and caliber of cord remains within normal.
1.Degenerative changes of cervical spine results in bilateral significant neural foraminal compromise at all levels as detailed. There is however no evidence of spinal canal compromise or stenosis at any level. The signal intensity and caliber of cervical and uppermost visualized thoracic cord is normal.2.There is also evidence of neural foraminal compromise at T1 -- T2 level due to degenerative changes and mild central spinal stenosis.