Anesthesia of skin [R20.0] / Paresthesia of skin [R20.2] / Muscle weakness (generalized) [M62.81], Reason for Study: ^Reason: evaluate for stroke History: R radial nerve sensorimotor distribution, R lower face Vc vs cervical branch, ?LUE tingling Brain MRIThere is no evidence of acute ischemic or hemorrhagic lesion.Scattered FLAIR high signal intensity lesions on by lateral hemisphere indicating nonspecific small vessel ischemic disease in this age.The ventricles, sulci and cisterns are symmetric and unremarkable. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia. The midline structures and cranial-cervical junction are normal. The paranasal sinuses and mastoid air cells are clear.Brain MRA3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate normal ICAs, MCAs and ACAs. Vertebrobasilar system appears to be normal.C-spine MRIThe cranial-cervical junction is normal. The spine alignment is anatomic but it lost normal cervical lordosis. The vertebral body height is preserved. The bone marrow and end plates demonstrate a normal MR appearance. The cord signal is normal. Degenerative changes are as follows;C1-C2: No evidence of neuroforaminal stenosis, no spinal stenosis.C2-C3: No evidence of neuroforaminal stenosis, no spinal stenosis.C3-C4: No evidence of neuroforaminal stenosis, no spinal stenosis.C4-C5: No evidence of neuroforaminal stenosis, no spinal stenosis.C5-C6: Focal central bulging of disc which abuts thecal sac. No evidence of neuroforaminal stenosis, no spinal stenosis.C6-C7: No evidence of neuroforaminal stenosis, no spinal stenosis. There is a relatively well circumscribed lesion within the right neuroforamen which shows CSF signal intensity without demonstrating evidence of mass effect (size=5.3mm). This lesion is most likely representing perineural cyst. The same character but slightly smaller (size=3.5mm)lesion is seen on the left side neuroforamen.C7-T1: No evidence of neuroforaminal stenosis, no spinal stenosis. Again, there are perineural cysts, one on the right side (3.5mm) and another on the left side (6.3mm).
1. No evidence of acute ischemic or hemorrhagic lesion.2. Non specific small vessel ischemic disease.3. Normal brain MRA.4. Focal central bulging of disc at the level of C5-6 which abuts thecal sac.5. Multiple perineural cysts at the level of C67 and C7T1, otherwise unremarkable C-spine MRI. 