CT of the head and right paracervical spine. 56-year-old male with daily headaches x 2 years. Also mass right neck, positive cervical radiculopathy. CT of brain without infusion:No evidence of hemorrhage, edema, mass effect, midline shift or hydrocephalus is detected. Cortical sulci, ventricular system and all CSF cisterns remain within normal limits. Calvarium, limited via paranasal sinuses, mastoid air cells and middle ear cavities are also within normal limits.CT of cervical spine without the infusion:The bony density and the alignment of cervical spine remains within normal limits. Degenerative disk disease including anteriorly projected bridging osteophytes, calcification and hypertrophic changes of posterior longitudinal ligament and bulging disks throughout the cervical spine are not. Degenerative changes at C3 -- C4 causes significant left neural foramina compromise and to a lesser degree of right neural foramina. A ventral hypertrophic spur at C5 -- C6 appears to be in contact with the cord with minimal posterior displacement of the cord. Heavy calcification of hypertrophy posterior longitudinal ligament posterior to C6 is noted. There is compromise of the left neuroforamina at C6 -- C7 level.There is no evidence of any destructive bony lesions. No evidence of any sclerotic bony changes. This examination is tailored primarily for CT of cervical spine and is not the appropriate test for evaluation of soft tissue masses ending at. Bilateral coarse soft tissue mass in the neck CT of the soft tissues of the neck with infusion or an MRI of the soft tissues of the neck is recommended.
1.Normal CT brain and calvarium without infusion.2.Degenerative changes of cervical spine with resultant multilevel neural foramina compromise as detailed.3.No evidence of any acute or sclerotic bony changes.4.This examination cannot evaluate for soft tissues of the neck since its tailored primarily for evaluation of cervical spine.5.If there is history of mass in the neck a dedicated CT of the soft tissues of the neck with infusion is recommended. 6.The findings were discussed with the clinical service pager # 4146( DR. Cathleen Mulcahy). Because a stated to the clinical service that this exam is not the appropriate test for detection of soft tissue mass in the neck. CT of the soft tissues of the neck with infusion is recommended for evaluation of possible mass in neck.