Male, 57 years old, with status epilepticus, history of epilepsy, new dysphagia requiring PEG. Brain: The ventricles and sulci are within normal limits. The basal cisterns remain patent. There is no midline shift or mass effect. There are no areas of abnormal signal. There is no diffusion abnormality. No extra-axial fluid collection is identified. No pathologic intracranial enhancement is identified.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. Moderate fluid signal is present within the right mastoid air cells. The paranasal sinuses are grossly clear.Cervical spine: Craniovertebral junction appears within normal limits. The cervical vertebral bodies are appropriate in height. Alignment is maintained. Bone marrow signal is within normal limits. The cervical spinal cord has normal signal characteristics and overall morphology. There is no pathologic enhancement in the cervical spine within limits of motion artifact. No high-grade spinal canal or neural foraminal stenoses are identified in the cervical spine.There are mild multilevel degenerative changes in the cervical spine, most prominent at C4-5. Small disc osteophyte complexes are present at C3-4 and C4-5 without significant spinal canal stenosis. Right uncal vertebral hypertrophy and facet arthropathy results in mild to moderate right and mild left neural foraminal narrowing at C4-5.A partially imaged soft tissue mass is present in the left supraclavicular region with heterogeneous signal and questionable enhancement. The imaged portion measures up to 2.4 cm. This was also seen on the outside CTA of the neck. A normal thyroid gland is not visualized.
1. Normal MRI appearance of the brain, specifically no seizure focus identified.2. No cervical spinal cord compression, abnormal spinal cord signal or pathologic intradural enhancement.3. Incidental partially imaged left supraclavicular mass measuring up to 2.4 cm. Correlation with outside imaging or dedicated imaging of the neck is suggested.4. Fluid signal in the right mastoid air cells may be inflammatory.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.