48-year-old male with dysarthria, LUE/LLE weakness and diffuse hyperreflexia. Evaluate for stroke. Brain MRI:There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is minimal scattered T2/FLAIR hyperintensities which are nonspecific. There is no abnormal intracranial enhancement. There is mild diffuse volume loss. The 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, paranasal sinuses, and scalp soft tissues are grossly unremarkable.C-spine MRI:There is straightening of the cervical spine lordosis The vertebral body and disk heights are well-maintained. There is variable disc desiccation. No worrisome focal marrow signal abnormality is appreciated. The spinal cord is of normal caliber and signal. There is no pathological enhancement. There are small disc osteophyte complexes involving the C3-4 through C6-7 levels with a superimposed small central disc protrusion at C6-7. There is at most mild to moderate spinal canal stenosis with flattening of the right paramedian ventral cord at C3-C4 and minimal neuroforaminal narrowing at the C3-4 and C6-7 levels.
1.No evidence of acute infarct. 2.Minimal scattered chronic small vessel ischemic changes.3.Degenerative changes in the cervical spine with at most mild to moderate spinal canal stenosis and flattening of the right paramedian ventral cord at C3-C4 as well as minimal neuroforaminal narrowing at the C3-4 and C6-7 levels.