Clinical question: Intracranial pathology? Signs and symptoms: Weak upper extremity and thoracic dilatation. Nonenhanced cervical MRI:There is normal anatomical alignment of vertebral column however with mild exaggeration of cervical lordosis.Unremarkable signal intensity of vertebral column other than mild changes secondary to degenerative disease.There is normal signal intensity and caliber of cervical and upper most visualized thoracic cord.There is no evidence of spinal canal compromise or stenosis at any level.Foramen magnum is unremarkable.C2-C3 demonstrate minimal degenerative changes and unremarkable otherwise.C3-C4 demonstrate moderate degenerative changes with resultant moderate bilateral neural foraminal compromise.C4-C5 demonstrate moderate degenerative changes with asymmetric right-sided facet hypertrophic changes. There is resultant significant right and mild left neural foraminal compromise.C5-C6 demonstrate moderate degenerative disease with asymmetrical right-sided facet hypertrophic changes resulting in significant right neural foraminal compromise.C6/C7 demonstrate mild disc disease and mild bilateral (right greater than left) facet hypertrophic changes without appreciable neural foraminal compromise.C7-T1 is unremarkable.Upper most visualized thoracic spine and thoracic cord demonstrate mild degenerative changes and unremarkable otherwise.
1.Normal signal intensity and caliber of cervical and upper most visualized thoracic cord.2.No evidence of central spinal stenosis at any level.3.Multilevel primarily right-sided neural foraminal compromise (some significantly) as detailed per level above.