53 years Female (DOB: 5/22/1962)Reason: cord lesions vs compression History: prior R Optic neuritis / now R side weaknessPROVIDER NAME: THOMAS J KELLY THOMAS J KELLY MRI brain:The CSF spaces are appropriate for the patient's stated age with no midline shift. There are several periventricular white matter lesions present some which are perpendicularly oriented to the lateral ventricles. Some extend to the corpus callosum. These are not associated with any contrast enhancement.There is a vague signal hypointensity present in the central portion of the lower brainstem on susceptibility weighted imaging on postcontrast imaging demonstrates linear enhancement suggesting this represents a vascular structure. It is associated with some T2 signal hyperintensity. It's possible this represents capillary telangiectasiaNo 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.The visualized portions of the paranasal sinuses demonstrate some minor mucosal thickening in the left maxillary sinus. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.MRI cervical spine:There is T2 signal hyperintensity within the cervical spinal cord extending from the C2-3 disc space level to the C4 vertebral body level measuring 5 x 26 mm in sagittal dimensions. It predominantly involves the right hemicord posteriorly. It appears to be associated with some vague enhancement that should be noted that the post contrast imaging is degraded by patient motion. There is a lesion nearly contiguous with the above described lesion present within the cervical spinal cord at the C2 vertebral body level which is also suspected to be associated with contrast enhancement.The cervical vertebral bodies are appropriate in overall alignment and height. There is multilevel disc desiccation present. There are foci of T1 signal hyperintensity within the C2, C3 and C5 vertebral bodies as well as the T2 and T3 vertebral bodies which most likely represent vertebral body hemangiomas.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 or neural foramina. There is a mild disc bulge present at this level.At C4-5 there is no significant compromise to the spinal canal or neural foramina. There is a mild disc bulge present at this level.At C5-6 there is no significant compromise to the spinal canal or neural foramina. There is a small left lateral recess disc protrusion at this level associated with some uncovertebral osteophytes and mild encroachment of the nerve roots at the left lateral recess.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.
1.There are upper cervical spinal cord lesions present associated with some suspected enhancement following contrast administration which would be suggestive of a subacute or acute demyelinating plaques. Some the post contrast imaging of the cervical spine is degraded by patient motion which may confound interpretation of contrast enhancement.2.There are are several periventricular white matter lesions present some which are perpendicularly oriented to the lateral ventricles and extending to the corpus callosum. There are number is somewhat limited. Demyelination is certainly a consideration here3.Findings raise the question of capillary telangiectasia versus a venous anomaly within the lower brainstem.4.There are some mild degenerative changes present in the cervical spine without significant compromise to spinal canal or exiting nerve roots. This is worse at C5-6 where there is some mild encroachment of left-sided exiting nerve roots.