Clinical question: Abnormal brain MRI and advanced; evaluate for progression. Signs and symptoms: Anesthesias. Nonenhanced brain MRI:Negative diffusion weighted series.Considering the difference between the 3T scanner utilized on current exam and 1.5T scan or on prior study there is no evidence of any definitive interval change in the extent of nonspecific foci of FLAIR and T2 hyperintensity in the subcortical and periventricular white matter of bilateral cerebral hemispheres and along the dorsal aspect of the lower pons since prior exam. Several of the lesions however are more conspicuous and appear larger on current exam which is believed to be due to better quality of this study. No convincing evidence of new lesions since prior exam. Mild prominence of supratentorial ventricular system with maintained midline measures identical to prior exam. The cerebral cortex and cortical sulci as well as the CSF spaces are otherwise unremarkable and stable since prior exam.Nonenhanced cervical MRI: Examination is compromised due to motion artifact which precludes assessment for subtle findings. Within this limitation examination demonstrates no signal abnormality of cervical or the upper most visualized thoracic cord. The caliber of the cord also remains within normal.The signal intensity in the alignment of the vertebral column is anatomical.There is no evidence of spinal canal compromise or central spinal stenosis at any level.Foramen magnum is unremarkable.C2-C3 demonstrate mild left neural foraminal compromise secondary to degenerative changes.C3-C4 is unremarkable.C4-C5 demonstrates mild bilateral neural foraminal compromise.C4-C5 demonstrate mild disc disease and loss of disc height, shallow bulging disc and moderate bilateral neural foraminal compromise.C6-C7 demonstrate mild disc disease and loss of disc height, mild bilateral ligamentum flavum hypertrophy. There is a right paramedian and lateral shallow broad-based disc protrusion (sagittal T2 and T2 STIR image 10 and axial T2 series 1501 image 8) with resultant partial effacement of ventral subarachnoid space and subtle flattening deformity of right aspect of the cord. No spinal stenosis or neural foraminal compromise.C7-T1 demonstrate mild degenerative changes with resultant mild left neural foraminal compromise and unremarkable otherwise.
1.Nonenhanced brain MRI demonstrate few foci of FLAIR/T2 hyperintensity in the periventricular and subcortical white matter and dorsal aspect of pons which are more conspicuous on current exam likely due to utilization of 3T scanner without convincing evidence of progression since prior study. Please review above comments. Unremarkable exam otherwise.2.Nonenhanced MRI of cervical spine is compromised due to motion artifact however within this limitation no convincing evidence of cord caliber or signal abnormality. Mild degenerative changes and including a shallow right paramedian and right lateral disc protrusion at C6/C7 as detailed. No spinal stenosis at any level. There are however neural foraminal compromise as detailed per level above.