Clinical question: Trauma secondary to MVA. Findings and symptoms: Headache. Nonenhanced brain MRI:No diffusion weighted abnormalities.There is normal anatomical morphology of brain. There is normal signal intensity of brain parenchyma on all MRI sequences. Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and brain myelination.The signal void of major intracranial arterial branches are identified. The signal intensity of the intracranial venous sinuses is within normal.Calvarium and soft tissues of the scalp are unremarkable.Orbits, paranasal sinuses and mastoid air cells are unremarkable.Nonenhanced cervical MRI:There is normal anatomical alignment of the vertebral column however with mild straightening of cervical lordosis.There is no detectable posttraumatic soft tissue or bony abnormality of vertebral column.There is mild uniform smaller than expected caliber of the spinal canal and which is highly suspected of a congenital anatomical variation of short pedicle.Foramen magnum is unremarkable.C2 -- C3 is unremarkable. C3 -- C4 demonstrate mild disk desiccation and loss of disk height, mild bilateral ( R >L) uncovertebral hypertrophy and subtle volume disk. There is mild right neural foraminal compromise. Minimal degenerative changes at this level with congenitally smaller size of the spinal canal results in mild central spinal stenosis.C4 -- C5 demonstrate mild disk disease and loss of disk height, bilateral uncovertebral hypertrophic changes and mild bulging disk is noted. Findings results in mild bilateral neural foraminal compromise and central spinal stenosis.C5 -- C6 demonstrate mild disk disease and loss of disk height, bilateral ( R > L ) uncovertebral hypertrophy is also present. Constellation of findings is seen significant right and mild to moderate left neural foraminal compromise and moderate central spinal stenosis.C6 -- C7 demonstrate minimal disk disease, mild uncovertebral hypertrophy on the left. No spinal stenosis and mild left neural foraminal compromise is noted.C7 -- T1 is unremarkable.Uppermost visualized thoracic spine and thoracic cord through T4 is unremarkable.
1.Unremarkable nonenhanced brain MRI.2.Nonenhanced cervical MRI demonstrate congenital anatomical variation of short pedicles/small canal. Mild degenerative changes at C3 -- C4, C4 -- C5 and C5 -- C6 levels with congenitally small canal results in mild to moderate central spinal stenosis and with neural foraminal compromise as detailed per level above. There is normal signal intensity and caliber of the cervical cord. There is no detectable posttraumatic changes of vertebral column for the perispinal soft tissues.