Migraine but persistent right V2 hypesthesias and increasing weakness voice, now some difficulty handling secretions. Brain: There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma and pituitary gland appear unremarkable. There is no abnormal intracranial enhancement. In particular, the paths of the trigeminal nerves appear unremarkable, including the cavernous sinuses and Meckel caves. 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, and scalp soft tissues are grossly unremarkable.Neck: The trigeminal fat pads are preserved. There is no evidence of measurable mass lesions or significant cervical lymphadenopathy, including a cluster of small left supraclavicular lymph nodes. There are multiple subcentimeter T2 hyperintense thyroid nodules that appear to enhance. The salivary glands and upper aerodigestive tract appear unremarkable. The major cervical flow voids are intact. There is multilevel degenerative spondylosis with indentation of the spinal cord at C4-5 and C5-6 secondary to disc-osteophyte complexes. There is a subcentimeter retention cyst in the right ethmoid sinus.
1. The trigeminal nerves appear unremarkable and there is no evidence of intracranial hemorrhage, mass, or acute infarct. 2. Multiple subcentimeter T2 hyperintense thyroid nodules. Further evaluation via ultrasound may be useful.3. Multilevel degenerative spondylosis with indentation of the spinal cord at C4-5 and C5-6.