66-year-old male with spinal cord cavernous malformation experiencing hand weakness. There has been interval C4 and C5 laminectomy with partial C3 laminectomy. A previously demonstrated T2 hyperintense intramedullary lesion is smaller measuring 14 mm craniocaudal by 6 mm AP (previously 18 mm x 9 mm). Redemonstrated is adjacent spinal cord hypointensity extending both above and below the lesion, which is unchanged in appearance. Extradural fluid is present which causes mild mass effect upon the dura, resulting in new mild to moderate central stenosis at C5-6. Enhancement is noted involving the soft tissues along the operative tract, as within the superior most aspect of the intramedullary lesion.C2/3 is unremarkable and unchanged.C3/4 demonstrate mild to moderate degenerative changes of the disk and the posterior elements. Additionally there is a prominent broad-based disk protrusion at this level. Constellation of findings of degenerative disease and larger disk protrusion results in mass effect, flattening and posterior displacement of the cord and moderate central spinal stenosis. There is inferior migration of disk fragment posterior to the body of C4 with associated mass effect and flattening deformity of the cord and central spinal stenosis as well. There is also moderate bilateral neural foraminal compromise. There is no convincing evidence of associated cord T2 hyperintensity at this level. These findings are unchanged.C4/5 mild disk disease and moderate bilateral facet hypertrophic changes and mild ligamentum flavum hypertrophy. There is a small broad-based disk protrusion also present at this level which results in flattening and posterior displacement of the cord and moderate central spinal stenosis. Moderate left and mild to moderate right neural foraminal compromise is present at this level. These findings are unchanged.C5/6 demonstrate degenerative changes with result in mild-to-moderate left and mild right neural foraminal compromise.C6/7 demonstrate mild disk and facet disease with resection of ligamentum flavum. No spinal stenosis or neural foraminal compromise, unchanged.C7/T1 is unremarkable with the exception of mild facet and ligamentum flavum hypertrophy, unchanged
There has been interval C4 and C5 laminectomy with partial C3 laminectomy. A previously demonstrated T2 hyperintense intramedullary lesion is smaller measuring 14 mm craniocaudal by 6 mm AP (previously 18 mm x 9 mm). Redemonstrated is adjacent spinal cord hypointensity extending both above and below the lesion, which is unchanged in appearance. Extradural fluid is present which causes mild mass effect upon the dura, resulting in new mild to moderate central stenosis at C5-6. Enhancement is noted involving the soft tissues along the operative tract, as within the superior most aspect of the intramedullary lesion.