Diagnosis: Migraine, unspecified, without mention of intractable migraine without mention of status migrainosusClinical question: Evaluate for cause of headaches The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.There is an isolated punctate subcortical white matter lesion on the medial aspect of the left temporal lobe. In isolation this is probably of little clinical significance and not unusual at this age.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.Findings suggest a disc protrusion at C4-5 with findings which are suspicious for spinal stenosis but cannot be confirmed on this exam.
1.MRI of the brain is within normal limits.2.Findings raise the question of disc extrusion in the cervical spine with possible spinal stenosis