Clinical question: Evaluate for left-sided weakness. Signs and symptoms: Left-sided weakness. Nonenhanced brain MRI:Examination is degraded due to motion artifact however diagnostic.Unremarkable diffusion weighted series.There is normal signal intensity of brain parenchyma on all MRI sequences.There is mild generalized prominence of cortical sulci for age which could be at the upper limits of normal. Unremarkable cerebral cortex, ventricular system, CSF spaces and brain myelination otherwise.The signal void of major intracranial arterial branches are identified.Unremarkable images through the orbits. Unremarkable calvarium and soft tissues of the scalp. Paranasal sinuses demonstrate mild chronic sinusitis of the sphenoid and unremarkable otherwise.Nonenhanced cervical MRI:Examination is degraded due to extensive motion artifact.Foramen magnum is unremarkable.C2-C3 is unremarkable.C3-C4 demonstrate mild degenerative changes with mild left neural foraminal compromise.C4-C5 demonstrate moderate disc disease and loss of disc height, left uncovertebral hypertrophic changes with resultant mild left neural foraminal compromise. There is a central disc extrusion at this level with resultant flattening deformity and posterior displacement of the cord and resultant mild central spinal stenosis. There is no convincing evidence of cord signal abnormality.C6-C7 demonstrate minimal degenerative changes and unremarkable otherwise.C7-T1 is unremarkable.Unremarkable upper most visualized thoracic spine and thoracic cord.
1.Nonenhanced brain MRI is unremarkable. Please see above comments.2.Nonenhanced cervical MRI is degraded due to motion artifact. Within this limitation there is a central disc extrusion at C4-C5 with resultant indentation deformity of the cord and subtle posterior displacement with mild central spinal stenosis at C4-C5 level and with mild left neural foraminal compromise. There is no detectable signal abnormality of the cord. Please see above comments.