Abnormality of gait [781.2], Reason for Study: ^Reason: r/o stenosis History: gait difficulties Extensive confluent high signal intensity lesions on bilateral periventricular white matter on FLAIR images indicating nonspecific ischemic lesions, comparing to prior scan, the extent of those lesions have aggravated.On Gradient echo images, there are multiple bihemispheric supra and infratentorial various sized susceptibility artifacts, these lesions could represent amyloid angiopathy. Possibility of cavernous malformation or calcifications are less likely. The ventricles, sulci and cisterns are symmetric and unremarkable. There is no mass, mass effect, edema, midline shift, or abnormal contrast enhancement. 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:The cranial-cervical junction is normal. There is exaggerated cervical lordosis. The cervical spine alignment is anatomic. The vertebral body height is preserved. The bone marrow and end plates demonstrate a normal MR appearance. The signal of the visualized cord is normal. Degenerative changes were as follows:C23: within normal limitsC34: within normal limitsC45: diffuse bulging of disc, no spinal stenosis, no neural foraminal stenosis.C56: diffuse bulging of disc, no spinal stenosis, no neural foraminal stenosis.C67: within normal limits.C7T1: within normal limits.L Spine:For the purpose of this dictation, the lowest visualized intervertebral disc space is labeled L5-S1. There is normal lumbar lordosis. The spine alignment is anatomic. The vertebral body height is preserved. The bone marrow demonstrate a normal MR appearance. The signal of the visualized cord is normal. The conus medullaris terminates at the L1-L2 level. There is no evidence of cord compression or mass. Degenerative changes are as follows:T12L1: within normal limitsL12: within normal limitsL23: diffuse bulging of disc with osteophyte especially on the right side of neural foramen resulting mild neural foraminal stenosis. L34: diffuse bulging of disc with bilateral ligamentum flavum thickening results mild bilateral neural foraminal narrowing. Modic 2 endplate changes are also seen.L45: disc dessication, Modic type 2 endplate changes. Diffuse disc bulging. No neural foraminal or spinal canal stenosis.L5S1: within normal limits
1. Interval progression of confluent patchy periventricular white matter changes since prior exam performed on Jun 5 2008.2. Multifocal various sized susceptibility artifacts indicate possibility of amyloid angiopathy. Clinical correlation is indicated.3. Degenerative changes of C and L spine as described above. Multilevel various sized disc degenerations. Mild neural foraminal stenosis at the levels of L23 and L34 were seen.