60 years Male (DOB: 6/20/1956)Reason: rule out C-spine lesion History: RUE weaknessPROVIDER NAME: THOMAS J. KELLY MRI brain:The CSF spaces are appropriate for the patient's stated age with no midline shift. There are several punctate T2 and FLAIR hyperintense foci present in the subcortical white matter of the superior frontal gyri bilaterally.Is a punctate focus of signal loss present in the subcortical white matter of the left frontal lobe on susceptibility weighted imaging most likely is represents a microhemorrhage which in isolation is most likely of little significance.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.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 demonstrate a mucous retention cyst in the left maxillary sinus and some mucosal thickening in the right maxillary sinus.. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.MRI cervical spine:The cervical vertebral bodies are appropriate in overall alignment and height. The cervical spinal cord has normal signal characteristics and overall morphology. No abnormal lesions are identified in the cervical spine. There is reversal of normal cervical curvature present which is centered at C5-6. There is some multilevel disc desiccation present.. There is a T1 hyperintense lesion present within the T3 vertebral body most likely representing a vertebral body hemangioma.At C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there is a disc bulge present associated with uncovertebral osteophytes and narrowing of the neural foramina bilaterally. This partial effacement of spinal fluid ventral and posterior spinal cord at this level resulting in a mild to moderate degree of spinal stenosis. There is encroachment of left-sided exiting nerve roots within the neural foramen at this level due to disc material. There is some mild encroachment of right-sided exiting nerve rootsAt C4-5 there is no significant compromise to the spinal canal or neural foramina.At C5-6 there is loss of disc space height, disc desiccation and a diffuse disc bulge associated with bilateral uncovertebral osteophytes and encroachment of the exiting nerve roots within the neural foramina bilaterally.At C6-7 there is disc desiccation as well as endplate uncovertebral osteophytes associated with a disc bulge and narrowing of the neural foramina bilaterally with encroachment of the left-sided exiting nerve roots and to a lesser degree right-sided exiting nerve roots.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact.
1.There are few subcortical white matter lesions present in the frontal lobes which are nonspecific but most likely vascular related at this age.2.There are multilevel degenerative changes present in the cervical spine with findings suggestive of spinal stenosis at C3-4 and neural foraminal encroachment of exiting nerve roots worse on the left side at C3-4, right side at C6-7 and bilaterally at C5-6 but also present on the left-side at C6-7 and on the right side at C3-4.