Reason: parkinsonism and memory loss History: as above 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.There is a 4 mm subependymoma lesion present along the left lateral ventricle which has a cystic appearance and follows spinal fluid on all pulse sequences. Most likely it represents a subependymomas cystThere is periventricular linear T2 and flair signal hyperintensity in the left periventricular white matter comparedNormal 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. There is multilevel disk desiccation presentC2 is congenitally fused to C3 .At C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there is no significant compromise to the spinal canal or neural foramina. There is a loss of disk space height and the disk bulge present at this level associated with mild facet hypertrophy.At C4-5 there is no significant compromise to the spinal canal or neural foramina. There is a disk bulge present at this level associated with loss of disk space height . There is narrowing of the right neural foramen.At C5-6 there is no significant compromise to the spinal canal or neural foramina. There are end plate and uncovertebral osteophytes present at this level. There is narrowing of the neural foramina bilaterally with encroachment of right-sided exiting nerve roots. There are some endplate reactive changes present at this level. There is mild narrowing of the spinal canal present at this level.At C6-7 there is no significant compromise to the spinal canal or neural foramina. There is a minor disk bulge at this level.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact.
1.There are degenerative changes present in the cervical spine worst at C5-6 where there is some mild encroachment of right-sided exiting nerve roots within the neural foramen.2.There is nonspecific findings present within the brain such as a subependymomas cyst and left periventricular white matter and lesion which are probably of little clinical significance.