Male, 70 years old, with spasticity in the bilateral upper extremities, lower extremities and with left lower extremity weakness. Also with episodes of decreased consciousness. Brain:Artifact is seen from presumed dystrophic calcifications along the left middle frontal gyrus. No restricted diffusion is seen. Fairly extensive patchy T2 hyperintensity within the periventricular regions, the subcortical white matter, the basal ganglia and brainstem show no significant interval change. Also unchanged is a small region of encephalomalacia and surrounding T2 hyperintensity within the right temporal lobe. No acute intracranial hemorrhage or any abnormal extra axial fluid collection is suspected. The ventricles and sulci are mildly prominent compatible with underlying parenchymal volume loss.C-spine:Motion artifact significantly degrades image quality. Within this limitation, the following observations are made.A slight reversal of the cervical lordosis is seen, likely degenerative in nature. Vertebral body heights are grossly preserved. Endplate degenerative signal abnormality is noted, but no worrisome marrow replacement or marrow edema is detected.Visualized spinal cord demonstrates normal signal intensity throughout.C2-3: No spinal canal stenosis or neuroforaminal narrowing. C3-4: Left facet hypertrophy. Minimal posterior disc-osteophyte complex formation. No spinal canal stenosis. Mild to moderate left foraminal narrowing. C4-5: Bilateral facet hypertrophy. Posterior disc-osteophyte complex formation asymmetric to the right which effaces the right lateral recess and causes a mild generalized spinal canal stenosis with ventral cord flattening. Moderate left and severe right foraminal narrowing. C5-6: Facet hypertrophy. Mild posterior disc-osteophyte complex formation. No significant spinal canal stenosis. Moderate to severe bilateral foraminal narrowing. C6-7: Facet hypertrophy. Mild posterior disc-osteophyte complex formation. No significant spinal canal stenosis. Mild left and moderate right foraminal narrowing. C7-T1: No spinal canal stenosis or neuroforaminal narrowing.
1.Sequelae of extensive chronic microvascular ischemic disease, with perhaps a small area of territorial ischemia in the right temporal lobe, are unchanged.2.No definite acute intracranial abnormality is seen.3.Relatively mild degenerative findings are noted in the cervical spine without significant spinal canal stenosis or cord impingement. Scattered foraminal narrowing is seen, most severely affecting the C4-5 and C5-6 levels.