71 years Male (DOB: 5/7/1945)Reason: spontaneous muscle movement History: muscle twitchingPROVIDER NAME: RIMAS V. LUKAS RIMAS V. LUKAS MRI brain: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 a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.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 some mild mucosal thickening.. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.MRI cervical spine:Examination is degraded by patient motion. This obscures adequate visualization of the neural foramina and spinal canal.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.At C2-3 there is no significant compromise to the spinal canal. The left neural foramen appears to be narrowed. There appears to be facet hypertrophy in the left side at this level and left uncovertebral osteophyte formation and to a lesser degree right uncovertebral osteophyte formation..At C3-4 there is loss of disc space height, disc desiccation and diffuse disc bulge. There are endplate uncovertebral osteophytes present at this level. There are some effacement of spinal fluid ventral and posterior the spinal cord at this level. Overall there is mild to moderate spinal stenosis. There is narrowing of the neural foramina bilaterally at this level. There appears be facet hypertrophy at this level.At C4-5 there is loss of disc space height, desiccation, disc bulge and endplate and uncovertebral osteophytes with some partial effacement of spinal fluid ventral but not posterior the spinal cord. There is facet hypertrophy and narrowing of the neural foramina bilaterally at this level with suspected encroachment of exiting nerve roots.At C5-6 there is loss of disc space height, disc desiccation and a mild disc bulge associated with endplate and uncovertebral osteophytes. Some degree of narrowing of the neural foramina is present. There is mild narrowing of the spinal canal at this level.At C6-7 there is loss of disc space height, disc desiccation and a mild disc bulge associated with endplate and uncovertebral osteophytes. Some degree of narrowing of the neural foramina is present. There is mild narrowing of the spinal canal at this level.At C7-T1 there is loss of disc space height, disc desiccation and a mild disc bulge associated with endplate and uncovertebral osteophytes. Some degree of narrowing of the neural foramina is present.The vertebral artery flow voids appear to be intact.
1.Examination of the cervical spine is degraded to patient motion artifact which will obscure more subtle abnormalities. There are multilevel degenerative changes present in the cervical spine with findings suspicious for neural foraminal encroachment at multiple levels and findings suspicious for mild to moderate spinal stenosis at the C3-4 level.2.Periventricular and subcortical white matter lesions of a mild degree are nonspecific. At this age they are most likely vascular related. 3.Examination of the brain is also degraded due to patient motion which may also obscure more subtle abnormalities.