 Brain:Asymmetry is noted of the lateral ventricles, right greater than left, which is most likely secondary to anatomic variation.There is a solitary, small, ovoid focus of susceptibility hypointensity within a peripheral posterior right temporal gyrus (series 9, image 46), without other associated signal abnormality.The ventricles and sulci are normal in size. The cerebellar tonsils are in normal position. There are no masses, mass effect or midline shift. The pituitary gland is normal in size. There is no evidence for intracranial hemorrhage or acute cerebral, brainstem or cerebellar infarction. No diffusion-weighted abnormalities are identified. There are no extraaxial fluid collections or subdural hematomas. The paranasal sinuses and mastoid air cells are clear. There is lack of visualization within the distal left vertebral artery. Correlation with the cervical MRI portion of today's studies demonstrates the left-sided transversarium foramina to be small, consistent with a congenitally hypoplastic left vertebral artery. However, portions of the cervical left vertebral artery fail to demonstrate a flow void. It is uncertain if this is due to past dissection or from non-visualization of the tiny lumen.Cervical spine:There is slight reversal normal upper cervical curvature. There are no fractures or subluxations. The marrow signal is benign. The cervical cord is normal in signal. The cervicomedullary junction is normal. The cerebellar tonsils are in normal position. Other than the aforementioned left vertebral artery findings, the visualized paraspinal contents are unremarkable.C2/3: UnremarkableC3/4: There is a tiny midline disc protrusion, partially effacing the anterior CSF, without associated cord deformation or central stenosis.C4/5: Minimal disc bulge without significant mass effect or stenosis.C5/6: There is a left paracentral disc protrusion which causes anterior left hemicord flattening without intrinsic cord signal abnormality. There is no resulting central stenosis.C6/7: UnremarkableC7/T1: UnremarkableBilateral facet hypertrophy with ligamentum flavum thickening at T2/3 encroachment bilateral neural foramina without significant resulting stenosis.Lumbar spine:Alignment is anatomic. There are no fractures or subluxations. The marrow signal is benign. The conus is normal in signal and morphology and terminates at an appropriate level. The visualized intra-abdominal and paraspinal contents are unremarkable.L1/2: UnremarkableL2/3: UnremarkableL3/4: There is a small left foraminal/lateral disc protrusion which abuts the adjacent L3 nerve roots. There is also mild left facet hypertrophy without resulting foraminal stenosis.L4/5: Mild bilateral facet hypertrophy without resulting foraminal stenosis.L5/S1:Disc desiccation, disc height loss, asymmetric bulge to the right, small superimposed right paracentral disc protrusion, endplate spurring eccentric to the left, and mild bilateral facet hypertrophy. There is abutment of the right S1 nerve root sheath origin without deformation. There is no central stenosis, although there is mild left neural foraminal and minimal right neural foraminal stenosis.
1.Asymmetry is noted of the lateral ventricles, right greater than left, which is most likely secondary to anatomic variation. Correlation with prior historical studies could help to determine if there has been interval change.2.There is a solitary, small, ovoid focus of susceptibility hypointensity within a peripheral posterior right temporal gyrus without other associated signal abnormality. This most likely represents a small focus of hemosiderin deposition, of uncertain etiology or clinical significance.3.There is lack of visualization within the distal left vertebral artery. Correlation with the cervical MRI portion of today's studies demonstrates the left-sided transversarium foramina to be small, consistent with a congenitally hypoplastic left vertebral artery. However, portions of the cervical left vertebral artery fail to demonstrate a flow void. It is uncertain if this is due to past dissection or from non-visualization of the tiny lumen.4.C3/4: There is a tiny midline disc protrusion, partially effacing the anterior CSF, without associated cord deformation or central stenosis.5.C5/6: There is a left paracentral disc protrusion which causes anterior left hemicord flattening without intrinsic cord signal abnormality. There is no resulting central stenosis.6.Bilateral facet hypertrophy with ligamentum flavum thickening at T2/3 encroachment bilateral neural foramina without significant resulting stenosis.7.L3/4: There is a small left foraminal/lateral disc protrusion which abuts the adjacent L3 nerve roots.8.L5/S1:Asymmetric bulge to the right with small superimposed right paracentral disc protrusion. There is abutment of the right S1 nerve root sheath origin without deformation. There is no central stenosis, although there is mild left neural foraminal and minimal right neural foraminal stenosis.