24 years Female (DOB:9/11/1991)Reason: stroke code activation History: stroke code activation. Left lower extremity weakness status post epidural catheter.PROVIDER/ATTENDING NAME: AMBER TRUEHART AMBER TRUEHART 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.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 are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.The perfusion acquisition could not be post process on Visage or Olea due to a problem with the data. Post processed perfusion information is available on the MRI Philips machine which shows no obvious defect.MRA brain:Antegrade flow is present in the distal internal carotid arteries, the distal vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries.There is no evidence for intracranial aneurysm or cerebrovascular occlusion.The PCOMAs are fairly large. The LVA is small relative to the RVA. There is extracranial origin of he right PICA.Thoracic spine:The thoracic vertebral bodies are appropriate in the overall alignment and height. The thoracic spinal cord has normal signal characteristics and overall morphology. There is no compromise of thoracic spinal canal or exiting nerve roots. Lumbar spine:Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall alignment and height. The conus medullaris on sagittal imaging is grossly intact. There is a linear T1 hyperintense and T2 hypointense focus measuring 20 millimeters in length and 2 millimeters in thickness in the posterior aspect of the thecal sac at the L2 vertebral body level located midline and adjacent to nerve roots of the cauda equina.At L5-S1 there is no significant compromise to spinal canal or neural foramina.At L4-5 there is no significant compromise to spinal canal or neural foramina. There is mild loss of disk space height and disk dessication at this level.At L3-4 there is no significant compromise to spinal canal or neural foramina.At L2-3 there is no significant compromise to spinal canal or neural foramina.At L1-2 there is no significant compromise to spinal canal or neural foramina.
1.There is an early subacute hemorrhagic appearing focus along the posterior aspect of the thecal sac which could be within a nerve sheath or adjacent to nerve roots in the cauda equina.2.There is no evidence for intracranial cerebrovascular occlusive disease.3.There is no evidence for acute cerebral infarction.