Diagnosis: Abnormal reflex. Other conditions of brain(348.89)Clinical question: left fronto parietal hypodensity on CT headSigns and Symptoms: right leg spastic, mildly weak, Babinski MRI brain:The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a mild degree of 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 demonstrate mild mucosal thickening in the right maxillary sinus. 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. There is mild reversal of the normal cervical curvature present.At C2-3 there is no significant compromise to the spinal canal or neural foramina. There is disk dessication present at this level. At C3-4 there is no significant compromise to the spinal canal or neural foramina. There is disk dessication present at this level. There is left sided facet hypertrophy at this level associated with mild narrowing of the left neural foramen. At C4-5 there is no significant compromise to the spinal canal or neural foramina. There is disk dessication present at this level. There is loss of disk space height at this level. There is a disk bulge at this level.At C5-6 there is no significant compromise to the spinal canal . There is disk dessication present at this level. There is loss of disk space height at this level. There is a disk bulge at this level. There are right sided uncovertebral osteophytes at this level associated with encroachment of the left exiting nerve roots.At C6-7 there is no significant compromise to the spinal canal or neural foramina. There is disk dessication present at this level. There is loss of disk space height at this level. There is a disk bulge 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.
1.There are multilevel degenerative changes in the cervical spine. There is no significant compromise to the spinal canal and only mild narrowing of the neural foramina 2.Periventricular and subcortical white matter changes of a mild degree are nonspecific. At this age they are most likely vascular related. 3.Mild reversal of the normal cervical curvature is a non-specific finding which can be seen with muscle spasm or patient positioning.