69-year-old female with nystagmus and ataxia. Evaluate for cerebellar degeneration or ischemia. MRI brain:There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma and pituitary gland appear unremarkable. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.MRI C-spine:The craniovertebral junction appears within normal limits. The cervical spine alignment is maintained and the cervical vertebral bodies and disc spaces are appropriate in height. The bone marrow signal is within normal limits. The cervical spinal cord has normal signal characteristics and overall morphology. The vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits.Interspace observations:C2-3 and C3-4: No significant compromise to the spinal canal or neural foramina.C4-5: Small disc osteophyte complex and mild facet hypertrophy. Mild left neuroforaminal narrowing. No right neuroforaminal or spinal canal stenosis.C5-6: Small disc osteophyte complex and left greater than right facet hypertrophy which causes mild to moderate left and mild right neuroforaminal narrowing. There is no spinal canal stenosis.C6-7: Small disc osteophyte complex and mild facet hypertrophy without significant compromise to the spinal canal or neural foramina.C7-T1: No significant compromise to the spinal canal or neural foramina.
No evidence of intracranial hemorrhage, mass, or acute infarct. Mild cervical degenerative changes most prominent at C4-5 and C5-6 levels where there is at most mild/moderate left neural foraminal narrowing. There is no spinal canal stenosis at any point in the cervical region.