 MRI brain:The CSF spaces are appropriate for the patient's stated age with no midline shift. No 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 are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.MRI cervical spine:The cervical vertebral bodies are appropriate in overall alignment and height. The cervical spinal cord has normal signal characteristics and overall morphology. No abnormal enhancing lesions are identified in the cervical spine.At C2-3 there is no significant compromise to the spinal canal or neural foramina. There is a disc bulge present at this level. There is associated posterior ligamentous hypertrophy present at this level.At C3-4 there is loss of disc space height, disc desiccation and a broad-based right lateral disc protrusion present extending across the midline and encroaching on the right-sided exiting nerve root within the neural foramen and impressing on the thecal sac effacing spinal fluid ventral and posterior the spinal cord crowding and moderate degree of spinal stenosis. There is associated posterior ligamentous hypertrophy present at this level.At C4-5 there is a broad-based right lateral disc protrusion present extending into the right neural foramen and encroaching the right-sided exiting nerve root within the neural foramen which also effaces spinal fluid ventral and posterior the spinal cord creating a mild to moderate degree of spinal stenosis. There is also bilateral uncovertebral osteophyte formation at this level with encroachment of the exiting nerve roots bilaterally.At C5-6 there are endplate and uncovertebral osteophytes present associated with a disc bulge, loss of disc space height and disc desiccation. There is effacement of spinal fluid ventral to the spinal cord at this level with a mild to moderate degree of spinal stenosis. There is narrowing of the neural foramina bilaterally with encroachment of exiting nerve roots bilaterally.At C6-7 there is loss of disc space height, disc desiccation and a left paramedian disc protrusion which extends into the left neural foramen and encroaches on the left-sided exiting nerve root within the neural foramen.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact.The patient's nasogastric tube is looped in the hypopharynx. An endotracheal tube is in place. The balloon of the endotracheal tube is larger than the size of the trachea.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. No abnormal enhancing lesions are identified in the thoracic spine. The balloon of the endotracheal tube is larger than the size of the trachea.There are small pleural effusions presentLumbar 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. No abnormal enhancing lesions are identified in the lumbar spine.At L5-S1 there is no significant compromise to spinal canal. There is a left far lateral disc protrusion present at this level. There is partial effacement of the fat in the left lateral recess and left neural foramen with mild to moderate encroachment of left exiting nerve roots at L5-S1 and mild encroachment of the nerve roots at the left lateral recess.At L4-5 there is left more than right facet hypertrophy associated with effacement of the fat surrounding the exiting nerve roots within the neural foramen bilaterally. There is effacement of the fat at the left lateral recess at this level with moderate encroachment of the exiting nerve roots bilaterally. There is mild left sided translation of L4 on L5 at this level. At L3-4 there is no significant compromise to spinal canal. There is a broad-based right lateral disc protrusion present at this level associated with mild encroachment of the right-sided exiting nerve roots.At L2-3 there is no significant compromise to spinal canal or neural foramina. There is a disc bulge present at this level associated with disc desiccation.At L1-2 there is no significant compromise to spinal canal or neural foramina.
1.There are multilevel degenerative changes present in the cervical spine with moderate spinal stenosis at C3-4 and mild to moderate spinal stenosis at C4-5 as well as bilateral encroachment of exiting nerve roots at C3-4, C4-5 and C5-6 and left-sided encroachment of exiting nerve roots at C6-7.2.There are multilevel degenerative changes present in the lumbar spine worse in the lower lumbar spine were there are some encroachment of the exiting nerve roots at the left lateral recess at L4-5 and encroachment of left-sided exiting nerve roots within the neural foramen bilaterally at L4-5 and on the left side at L5-S13.There are small pleural effusions present.4.Stacked axial T2 and non-contrast T1 images of the lumbar spine were not performed.5.No abnormal enhancing lesions are identified within the brain.