Clinical question: leg dystonia and memory and personality change. Signs and Symptoms: As above Pre and post enhanced brain MRI:Negative diffusion weighted series.There is a slight prominence of high convexity bilateral parietal cortical sulci for patient's stated age of 41.The signal intensity and anatomical morphology of the brain otherwise remains within normal on all MRI sequences.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and brain myelination.Post contrast images demonstrate no detectable abnormal parenchymal or leptomeningeal enhancement.Signal void of major intracranial arterial branches are identified and unremarkable.Signal intensity of intracranial venous sinuses is within normal and with normal pattern of enhancement.Unremarkable images through the orbits and including axial fat sat post enhanced series.Visualized paranasal sinuses and bilateral mastoid air cells and middle ear cavities demonstrate normal pneumatization signal patterns.Pre- and post enhanced total spine MRI:Examination of cervical spine demonstrate normal signal intensity and caliber of cervical cord without abnormal enhancement.There is normal signal intensity and anatomical alignment of vertebral column without detectable abnormal enhancement.No significant degenerative disc disease, no spinal stenosis or neural foraminal compromise at any level is detected. Unremarkable perispinal soft tissues.Formation of the thoracic spine demonstrate normal signal intensity and anatomical alignment of vertebral column without abnormal enhancement. There is mild exaggeration of thoracic kyphosis. No significant degenerative disease or spinal canal compromise at any level is detected. There is also no convincing evidence of neural foraminal compromise at any level.The signal intensity and caliber of the thoracic cord is within normal and without detectable enhancement of the cord or the meninges.Examination of lumbosacral spine demonstrate normal anatomical alignment and signal intensity of vertebral column and without abnormal enhancement. No appreciable significant degenerative disease and no spinal stenosis or neural foraminal compromise at any level.Normal signal intensity and caliber of the lower most visualized thoracic spine and thoracic cord, conus and the cauda equina and without detectable abnormal enhancement.Unremarkable paraspinal soft tissues.
1.Brain MRI demonstrate slight symmetrical bilateral prominence of high convexity parietal cortical sulci for patient's stated age without detectable signal abnormality or enhancement. Unremarkable pre and post enhanced brain MRI otherwise as detailed.2.Pre- and post enhanced total spine MRI is unremarkable.