59 years Male (DOB: 6/25/1957)Reason: evaluate for inflammatory lesions or tumors History: new onset facial palsy and other focal deficitsPROVIDER NAME: JAMES R. BRORSON JAMES R. BRORSON MRI brain:The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal enhancing 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. There appears to be a 6 mm in the distal right vertebral artery just proximal to the origin of the right posterior inferior cerebellar artery.The visualized portions of the paranasal sinuses demonstrate partial opacification of the posterior ethmoid air cells and mucosal thickening in the right frontal sinus as well as a mucous retention cysts in the maxillary sinuses. 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 enhancing lesions are identified in the cervical spine. There is a 2mm T2 hyperintense focus in the right hemicord at the C6 vertebral level.At C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there is no significant compromise to the spinal canal. There is left-sided facet hypertrophy present at this level associated with mild narrowing of the left-sided neural foramen.At C4-5 there is no significant compromise to the spinal canal or neural foramina.At C5-6 there is no significant compromise to the spinal canal. There are endplate and uncovertebral osteophytes at this level associated with narrowing of neural foramina. There are some mild endplate reactive changes present.At C6-7 there is no significant compromise to the spinal canal or neural foramina.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact.Thoracic spine:The thoracic vertebral bodies are appropriate in the overall alignment and height. The thoracic spinal cord has normal signal characteristics. At the T5-6 level of the spinal cord is displaced anteriorly and mildly narrowed in its AP dimension, however no distinct lesion is identified associated with this. There is no compromise of thoracic spinal canal or exiting nerve roots. No abnormal enhancing lesions are identified in the thoracic spine.
1.There is mild displacement of the thoracic spinal cord anteriorly raising the question of a possible adhesion to the dura and herniation.2.Findings suggest a 6-7mm right vertebral artery aneurysm. A CT angiogram may help further evaluate this.3.A 2 mm lesion within the right hemicord at the C6 level is present. There is nonspecific and may relate to prior injury.