Chest pain, unspecified [786.50] / Cervicalgia [723.1], Reason for Study: ^Reason: please r/o ischemia, vs mass, vs structural abnormality History: left sided weakness. Brain MRI:There is no evidence of acute ischemic or hemorrhagic lesion.There is a focal susceptibility artifact on the right temporal lobe on gradient echo images indicating small blood product. The possibility of cavernous malformation of this lesion cannot be completely excluded, however, the chance appear to be low considering the configuration of the lesion.Multifocal scattered high signal intensity lesions on bilateral deep white matter and periventricular white matter on FLAIR images indicate nonspecific small vessel disease.There is a large developmental venous malformation on the right cerebellar hemisphere.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, or abnormal contrast enhancement. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The mastoid air cells are clear.Small retention cyst on the left side sphenoid sinus.Thornwaldt cyst was also seen.Brain MRA:3D 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:There is about 6mm sized T1 low and T2 high signal intensity well marginated lesion within the odontoid process of C2 indicating benign nature cystic lesion such as osteochondral cyst.There is evidence of atlanto-occipital assimilation, right greater than left.Severe neural foraminal stenosis on the right side of C23, C34, and mild neural foraminal stenosis on the C45 right side, C67 left side.There is no evidence of spinal canal stenosis.Spinal cord signal intensity appears to be normal.
1. No evidence of acute ischemic or hemorrhagic lesion.2. A small susceptibility artifact on the right temporal lobe anterior aspect, possible prior hemorrhagic focus or small cavernous malformation.3. Non specific white matter lesions on FLAIR and T2 weighted images.4. Developmental venous anomaly on the right cerebellar hemisphere 5. Normal MRA of brain.6. Degenerative disease of C-spine, multilevel various degree neural foraminal stenosis as described above.