Rule out acute infarct or lesion. History of numbness on right side. Brain: No significant brain parenchymal signal abnormality. 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. There is cerebellar tonsillar ectopia measuring up to 4 mm below the foramen magnum similar to prior without clear evidence of Chiari I. No significant crowding in the posterior fossa. 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. Bone marrow signal and extracranial soft tissues are within normal limits. Cervical: Craniovertebral junction appears within normal limits. The cervical vertebral bodies are appropriate in height. Alignment is maintained aside from mild loss of cervical lordosis which may positional. Bone marrow signal is within normal limits. The cervical spinal cord has normal signal characteristics and overall morphology.Minimal 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: Minimal disc bulge with small central protrusion. No significant compromise to the spinal canal or neural foramina.C4-5: Minimal disc bulge. No significant compromise to the spinal canal or neural foramina.C5-6: No significant compromise to the spinal canal or neural foramina.C6-7: No significant compromise to the spinal canal or neural foramina.C7-T1: 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.
1. Brain MRI is essentially unremarkable. There is cerebellar tonsillar ectopia without significant crowding in the posterior fossa or evidence of Chiari I malformation.2. Cervical spine MRI is also essentially unremarkable. There are minimal degenerative changes without significant spinal canal or neural foraminal stenosis or cord signal abnormality at any level. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.