Generalized weakness. Evaluate for stroke. Brain: No restricted diffusion to suggest acute ischemia. No intracranial hemorrhage. No intracranial mass or mass-effect. The ventricles are within normal limits in size and configuration. Several foci of T2/FLAIR hyperintensity are seen in the bilateral subcortical and periventricular white matter, which are nonspecific, but compatible with mild chronic small vessel ischemic changes. Brain parenchyma is otherwise unremarkable for age. Major flow-voids are preserved.Sella and orbits are grossly within normal limits. Paranasal sinuses and mastoid cells are clear. There is heterogeneous low T1 marrow signal involving the calvarium is nonspecific. No destructive osseous lesions are seen.Cervical Spine:Craniovertebral junction appears within normal limits. The cervical vertebral bodies are appropriate height. There is reversal of normal cervical lordosis with apex at the C5-C6 level which may be in part positional. Alignment is otherwise maintained. There is mild diffuse low T1 marrow signal as well as degenerative endplate signal changes C5-C6. There is nonspecific 7-mm focus of T2 hyperintensity involving the C7 vertebral body. No destructive osseous lesions.The cervical spinal cord has normal signal characteristics and overall morphology.Mild degenerative changes are seen in the cervical spine as described below:C2-3: No significant compromise to the spinal canal or neural foramina.C3-4: No significant compromise to the spinal canal or neural foramina.C4-5: No significant compromise to the spinal canal or neural foramina.C5-6: Small disk osteophyte complex with effacement of the ventral thecal sac greater on the left. There is mild stenosis. No significant compromise to the spinal canal or neural foramina.C6-7: Small disk osteophyte complex with partial effacement of the ventral thecal sac. No significant compromise to the spinal canal or neural foramina.C7-T1: Small disk osteophyte complex with partial effacement of the ventral thecal sac. Minimal left neural foramina narrowing otherwise no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits. Endotracheal tube and enteric tube noted.
1. No evidence of acute ischemia or intracranial mass effect.2. Minimal chronic small vessel ischemic changes. MRI the brain is otherwise unremarkable for age.3. Mild degenerative changes in the cervical spine. There is mild spinal canal narrowing at C5-6 on the left. Otherwise no significant spinal canal or neural foramina stenosis in the cervical spine. No abnormal cord signal or evidence of cord compression.4. Nonspecific diffuse low T1 marrow signal which is nonspecific but can be seen in conditions such as chronic anemia.5. Subcentimeter T2 hyperintense lesion at the C7 vertebral body is nonspecific. Possibilities include an atypical hemangioma as well as other etiologies; follow-up CT or MRI can be considered as clinically appropriate.