Syncope and collapse [R55], Reason for Study: ^Reason: r/o ischemia or structural lesion History: syncopal episodes with LOC Brain MRINo evidence of acute ischemic or hemorrhagic lesion.The ventricles, sulci and cisterns are unremarkable. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, or restricted diffusion/acute ischemia. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.C-spine MRIThere are T2 high signal intensity lesions within the spinal cord at the level of C2-3 and C3-4 indicating cervical cord myelopathy. On axial scan, at the level of C2-3 and C3-4 there are broad-based central disc extrusion which compresses thecal sac as well as spinal cord. Another disc protrusion is seen at the level of C6-7 which compresses thecal sac and spinal cord.The cranial-cervical junction is normal. The spine alignment is anatomic. The vertebral body height is preserved. Degenerative changes are as followsC12: Within normal limitsC2-3: Mild to moderate bulging of disc which abuts thecal sac. No evidence of spinal cord compression.C3-4: Globular shaped central disc extrusion with broad-based which compresses the thecal sac and spinal cord results severe spinal canal stenosis and T2 high signal intensity within the spinal cord indicating compressive myelopathy.C4-5: broad-based disc protrusion compresses thecal sac and spinal cord results severe spinal canal stenosis and T2 high signal intensity within the spinal cord indicating compressive myelopathy.C5-6: Diffuse bulging of disc which abuts thecal sac. No evidence of spinal cord signal abnormality. C6-7: Central to left broad-based disc protrusion which compresses thecal sac results in moderate spinal canal stenosis. No evidence of spinal cord signal abnormality.C7-T1: Within normal limits
1. Unremarkable brain MRI.2. Severe spinal canal stenosis with compressive myelopathy due to cervical disc herniation at the level of C34 and C45 level.3. Disc protrusion at the level of C56 and C67 without evidence of spinal cord signal abnormality.