 There is straightening of the normal cervical lordosis. The vertebral body and disc space heights are preserved with slight disc desiccation at C5-6. The vertebral bone marrow signal is unremarkable. There are mild disc bulges at C3-4 through C5-6 but no significant spinal canal stenosis. The paravertebral soft tissues are unremarkable.There are T2 hyperintense lesions involving the right aspect of the spinal cord at the upper C4 and lower C5 levels. The right aspect of the cord appears slightly expanded at C4 and there is questionable faint, ill-defined enhancement along the medial aspect of the lesion. Otherwise, there is no abnormal enhancement within the cord at any level.A small, ill-defined focus of enhancement is seen within the cerebellum. This was better visualized on the recent brain MRI and is again favored to represent a small vascular anomaly.
T2 hyperintense spinal cord lesions at C4 and C5. The lesion at C4 slightly expands the cord and may have faint enhancement indicating a more acute finding. This is suspicious for a demyelinating process particularly given the findings on the recent brain MRI. However, inflammatory and vasculitic processes remain in the differential.