54 years Female (DOB:2/19/1962)Reason: evaluate for structural lesions or hematoma History: car accident 2 weeks ago, still with headachesPROVIDER/ATTENDING NAME: THOMAS J KELLY CHRIS V ALBANIS 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.Normal vascular flow voids are present in the distal carotid and right 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 left vertebral artery is diminutive intracranially.The visualized portions of the paranasal sinuses demonstrate mucous retention cysts in the maxillary sinuses. 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. 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.At C4-5 there is no significant compromise to the spinal canal. There is loss of disc space height, disk desiccation and endplate osteophytes at this level associated with the right lateral recess disc protrusion which encroaches on the nerve roots within the right neural foramen. There is mild narrowing of the left neural foramen at this level. There is partial effacement of spinal fluid ventral to the spinal cord at this level. There is mild ligamentum flavum hypertrophy present.At C5-6 there is no significant compromise to the spinal canal. There is loss of disc space height, disk desiccation and endplate osteophytes at this level associated with the right lateral recess disc protrusion which encroaches on the nerve roots within the right neural foramen. There is partial effacement of spinal fluid ventral to the spinal cord at this level. There is mild ligamentum flavum hypertrophy present.At C6-7 there is no significant compromise to the spinal canal or neural foramina. There is mild disc bulge present 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. The left vertebral artery is much smaller than the right vertebral artery diameter.
1.No intracranial mass lesion or hematoma is appreciated.2.Intracranial portion of the left vertebral artery is not readily identified. Most likely this is related to hypoplasia. If there is concern for vertebral artery dissection or occlusive disease, an MR angiogram of the head and neck with dissection protocol may be helpful.3.There are degenerative changes present cervical spine with some encroachment of the right-sided exiting nerve roots at C4-5 and C5-6.