Clinical question: Chronic tremor and ataxia. Signs and symptoms: Apraxia. Pre-and post enhanced cervical MRI:There is normal anatomical alignment the vertebral column.There is straightening of cervical lordosis.There is mild to moderate degenerative disk disease and C3 -- C4 to C6 -- C7 levels.There is normal signal intensity and caliber of the cervical cord.Foramen magnum is unremarkable.C2 -- C3 demonstrate mild degenerative changes without spinal canal or neural foraminal compromise/stenosis.C3 -- C4 demonstrate moderate disk disease and loss of disk height with resultant significant left and mild right neural foraminal compromise and mild central spinal stenosis.C4 -- C5 demonstrate mild degenerative changes with resultant mild left neural foraminal compromise. No central spinal stenosis. Tiny centrally located disk protrusion is present.C5 -- C6 demonstrate moderate degenerative changes, broad-based bulging disk with resultant significant right and moderate left neural foraminal compromise and mild central spinal stenosis.C6 -- C7 demonstrate mild disk disease and shallow bulging disk without spinal stenosis or neural foraminal compromise.C7 -- T1 demonstrate mild right neural foraminal compromise and unremarkable.Uppermost visualized thoracic spine and thoracic cord to T4 level is unremarkable.
1.Pre-and post enhanced cervical MRI demonstrate mild to moderate degenerative disk disease with resultant mild central spinal stenosis at C3 -- C4 and C5 -- C6 levels.2.Degenerative changes also results in significant right neural foramina and mild left at C3 -- C4, mild neural foraminal compromise on the left at C4 -- C5 and significant right and moderate left neural foraminal compromise at C6 -- C7 levels as detailed.3.There is mild flattening deformity of the ventral aspect of the cord secondary to disk disease at C3 -- C4 and C5 -- C6 levels. The signal intensity of the cord however remains within normal.