70 years, Male, new right hand and arm weakness.. Brain: No restricted diffusion to suggest acute ischemia. No intracranial hemorrhage. No intracranial mass or mass-effect. The ventricles are within normal limits in size and configuration. Several foci of T2/FLAIR hyperintensity are seen in the bilateral subcortical and periventricular white matter, which are nonspecific, but compatible with mild chronic small vessel ischemic disease. Brain parenchyma is otherwise unremarkable for age. Major flow-voids are preserved.Sella and orbits are grossly within normal limits. Paranasal sinuses and mastoid cells are clear. Bone marrow signal and extracranial soft tissues are within normal limits. Cervical spine: Craniovertebral junction appears within normal limits. The cervical vertebral bodies are appropriate in height. There is loss of normal cervical lordosis with minimal anterolisthesis of C4 on C5, minimal retrolisthesis of C5 on C6 and C6 on C7, and minimal C7-T1 anterolisthesis. The cervical spinal cord has normal signal characteristics and overall morphology.Degenerative changes are seen in the cervical spine as described below:C2-3: No significant compromise to the spinal canal or neural foramina.C3-4: There is disc osteophyte complex and uncovertebral hypertrophy resulting in mild spinal canal narrowing. There is moderate bilateral neural foraminal stenosis.C4-5: Small disc osteophyte complex with mild spinal canal narrowing. Mild right-sided neural foraminal stenosis. Minimal left neural foraminal narrowing.C5-6: Small disc osteophyte complex and uncovertebral hypertrophy. Minimal spinal canal stenosis. There is mild to moderate bilateral neural foraminal narrowing.C6-7: No significant spinal canal stenosis. Minimal neural foraminal narrowing bilaterally.C7-T1: No significant compromise to the spinal canal. Minimal bilateral neural foraminal narrowing.The vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits.
1. No evidence of acute infarct. No intracranial mass effect.2. Mild chronic small vessel ischemic disease.3. Mild to moderate multilevel degenerative changes in the cervical spine. No cord signal abnormality. There is mild spinal canal stenosis from C3-C4 to C5-C6. Neural foraminal narrowing is worst at the C3-C4 level and relatively worse on the right than the left.