Acute posttraumatic headache, neck pain, and left arm weakness and numbness. BRAIN:There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma and pituitary gland appear unremarkable. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The small chronic left orbital medial and floor blowout fractures are unchanged. The orbits are otherwise unremarkable. The chronic right nasal fracture is not well demonstrated. There is no other skull fracture and scalp soft tissues are grossly unremarkable accounting for artifact partially obscuring the right frontal scalp. CERVICAL SPINE:The study is at least mildly degraded by motion.The sagittal alignment is anatomic. There is no evidence of fracture. The vertebral bodies are preserved in height. There is multilevel disc-osteophyte degenerative disease that is most pronounced at C7-T1 and C6-C7, where dorsal osteophytes do mildly narrow the spinal canal. Uncovertebral proliferative change results in mild-to-moderate foraminal stenoses, most notable for moderate bilateral T1-T2 and right C6-C7 foraminal stenoses. The paravertebral soft tissues are unremarkable. STIR imaging shows no significant edema in the pre or paravertebral soft tissues and ligaments. The spinal cord, accounting for motion, shows no signal abnormality. There is no epidural hematoma.BRACHIAL PLEXUS:The study is at least mildly degraded by motion. There is also artifact overlying the right mid clavicular portion. Otherwise, there is no mass or signal abnormality along the course of the brachial plexus on either side. However, there are changes suggestive of bilateral rotator cuff pathology manifested by abnormal signal within and between the tendons as well as subjacent marrow signal abnormality and joint fluid. These findings are not adequately assessed on this examination.
1.Brain: Unremarkable examination with no acute intracranial hemorrhage or mass/mass-effect.2.Cervical spine: Degraded by motion. No MR evidence for acute osseous or soft tissue injury. Multilevel degenerative cervical spondylosis resulting in mild spinal canal stenosis and up to moderate foraminal stenoses as described above.3.Brachial plexus: Degraded by motion. No gross brachial plexus abnormality. However, there are changes of bilateral rotator cuff pathology but are not completely assessed. If clinically indicated, shoulder MRI would provide better assessment.