40 years Female (DOB: 1/31/1976)Reason: Evaluate for syringomyelia History: prior diagnosis of Chiari, headache with valsalva, and LUE numbnessPROVIDER NAME: THOMAS J KELLY THOMAS J KELLY MRI brain:The CSF spaces are appropriate for the patient's stated age with no midline shift. There are several punctate periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images. No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.MRI cervical spine:The cervical vertebral bodies are appropriate in overall alignment and height. The cervical spinal cord has normal signal characteristics and overall morphology. No abnormal enhancing lesions are identified in the cervical spine. The cerebellar tonsils extend 8 mm below the level of foramen magnum.At C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there is no significant compromise to the spinal canal or neural foramina.At C4-5 there is no significant compromise to the spinal canal or neural foramina.At C5-6 there is no significant compromise to the spinal canal or neural foramina. There is a minor disc bulge present at this levelAt C6-7 there is no significant compromise to the spinal canal or neural foramina. There is a mild disc bulge present at this level.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact.
Findings are compatible with Chiari I malformation. There is no associated evidence for ventriculomegaly or syrinx.Periventricular and subcortical white matter signal changes of a mild degree are present which are nonspecific. Most likely given their small number these are of little clinical significance. It is conceivable that these could be vascular related, related to demyelination, trauma, vasculitis, sarcoid. They are nonspecific. 