Pathological hyper-reflexia. Brain: There is no evidence of intracranial hemorrhage, mass, or acute infarct. There are minimal scattered nonenhancing punctate foci of cerebral white matter T2 hyperintensity. There is a left cerebellar hemisphere developmental venous anomaly. 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 orbits, skull, mastoid air cells, and scalp soft tissues are grossly unremarkable. There is mild mucosal thickening in the bilateral maxillary sinuses. Cervical Spine: The vertebral column alignment is within normal limits. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is unremarkable. There is a small disc-osteophyte complex at C5-6, but no significant spinal canal stenosis. The spinal cord displays normal signal and morphology. The paravertebral soft tissues are unremarkable. However, there is a heterogeneous nodule in the right tracheoesophageal groove that measures up to approximately 20 mm.
1. Minimal scattered punctate foci of cerebral white matter T2 hyperintensity are nonspecific. Otherwise, no characteristic findings to suggest multiple sclerosis, for example. 2. Incidental left cerebellar hemisphere developmental venous anomaly. 3. No evidence of cervical spinal cord compression or demyelinating lesions.4. A nodule in the right tracheoesophageal groove that measures up to approximately 20 mm may represent a thyroid lesion. A thyroid ultrasound may be useful for further evaluation.