85 years Male (DOB:9/10/1930)Reason: cognitive impairment History: memory lossPROVIDER/ATTENDING NAME: JAMES A MASTRIANNI JAMES A MASTRIANNI MRI brain:The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a moderate degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.A punctate focus of signal loss and susceptibility weighted imaging is present in the left orbital gyrus subcortical white matter.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses demonstrate some mucosal thickening. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. The eyeball lenses are thin.Cervical spine:The cervical vertebral bodies are appropriate in overall alignment and height. The cervical spinal cord has normal signal characteristics and overall morphology.At C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there are endplate and uncovertebral osteophytes at this level associated with ligamentum flavum hypertrophy. There is partial effacement of spinal fluid ventral and posterior the spinal cord at this level. There is encroachment of the exiting nerve roots within the neural foramina bilaterally at this level. Overall there is a mild degree of spinal stenosis at this levelAt C4-5 there is no significant compromise to the spinal canal or neural foramina. There are some disc desiccation at this level. There is mild facet hypertrophy at this level.At C5-6 there is endplate and uncovertebral osteophytes present associated with mild ligamentum flavum hypertrophy. There is encroachment of the exiting nerve roots bilaterally within the neural foramina. There is partial effacement of spinal fluid ventral and posterior the spinal cord at this level.At C6-7 there is a disc bulge associated with endplate and uncovertebral osteophytes and encroachment of the exiting nerve roots within the neural foramina bilaterally.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact.
1.Periventricular and subcortical white matter lesions of a moderate degree are nonspecific. At this age they are most likely vascular related. 2.There is mild ventriculomegaly present which is a nonspecific finding. One possibility is that it is related to normal pressure hydrocephalus in the appropriate clinical setting.3.There is a microhemorrhage present along the left orbital gyrus.4.There are multilevel degenerative changes present in the cervical spine with mild-to-moderate spinal stenosis C3-4 and bilateral encroachment of exiting nerve roots within the neural foramina at C3-4 and C5-6 and C6-7. There is mild spinal stenosis at C5-6.