 Brain MRI:There are a few scattered punctate foci of T2 hyperintensity within the white matter without associated mass effect, restricted diffusion or susceptibility abnormality. The ventricles and sulci are normal in size. The cerebellar tonsils are in normal position. There are no masses, mass effect or midline shift. Note is made of a partially up the sella. There is no evidence for intracranial hemorrhage or acute cerebral, brainstem or cerebellar infarction. No diffusion-weighted abnormalities are identified. There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. Mucosal thickening is present within bilateral maxillary sinuses. The remaining paranasal sinuses and mastoid air cells are clear. Cervical spine MR:Anterior wedge deformity is noted C5, C6, and C7 with fusion of the C5 and C6 vertebral bodies anteriorly. These changes are chronic given the lack of STIR signal. Associated with this is reversal of normal upper cervical curvature as well as levoscoliosis. The cervical and upper thoracic cord are normal in signal. The cervicomedullary junction is normal. The cerebellar tonsils are in normal position. The visualized paraspinal contents are unremarkable.C2/3: Disc bulge, ligamentum flavum thickening, and right facet hypertrophy. There is mild central and mild right neural foraminal stenosis.C3/4: Grade 1 anterolisthesis, osteophyte disc complex, bilateral uncinate hypertrophy, and bilateral facet hypertrophy. There is moderate to severe central, moderate to severe left neural foraminal, and severe right neural foraminal stenosis.C4/5: Osteophytic disc complex, bilateral facet hypertrophy, and bilateral facet hypertrophy. There is moderate to severe bilateral neural foraminal stenosis.C5/6: Osteophyte disc complex, bilateral facet hypertrophy, and bilateral facet hypertrophy. There is moderate bilateral neural foraminal stenosis.C6/7: Osteophyte disc complex and bilateral uncinate hypertrophy. There is mild bilateral neural foraminal stenosis.C7/T1: Osteophyte disc complex and facet hypertrophy. There is severe left neural foraminal and moderate to severe right neural foraminal stenosis.
1.Anterior wedge deformity is noted C5, C6, and C7 with fusion of the C5 and C6 vertebral bodies anteriorly. These changes are chronic given the lack of STIR signal. Associated with this is reversal of normal upper cervical curvature as well as levoscoliosis.2.C2/3: Mild central and mild right neural foraminal stenosis.3.C3/4: Moderate to severe central, moderate to severe left neural foraminal, and severe right neural foraminal stenosis.4.C4/5: Moderate to severe bilateral neural foraminal stenosis.5.C5/6: Moderate bilateral neural foraminal stenosis.6.C6/7: Mild bilateral neural foraminal stenosis.7.C7/T1: Severe left neural foraminal and moderate to severe right neural foraminal stenosis.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.