Clinical question: Evaluate for ischemia, etiology of seizures. Signs and symptoms: As above. Nonenhanced brain MRI:No acute intracranial process and negative diffusion weighted series.Examination demonstrates a slight generalized prominence of cortical sulci which may be at the upper limits of normal for stated age. Ventricular system remains within normal size and with maintained midline.Images through posterior fossa demonstrates significant cerebellar diaphragm and volume loss in particular along its superior aspect as was noted on prior head CT. As finding is not associated with any detectable signal abnormality. There is resultant mild ex vacuo dilatation of the fourth ventricle.Findings could be result of seizure treatment however less likely possibility of neurodegenerative disease cannot be entirely excluded.The signal void of major intracranial arterial branches are identified.The signal intensity of the intracranial venous sinuses demonstrate no abnormality.Unremarkable orbits, calvarium, soft tissues of the scalp, paranasal sinuses and mastoid air cells.Nonenhanced cervical spine MRI:Examination of cervical spine is severely limited due to significant motion artifact which makes precise assessment not possible.The signal intensity of the vertebral column demonstrate no definitive abnormality. There is straightening of cervical lordosis and suggestion of at least partial fusion at C6-C7. The caliber and the signal intensity of the cord remains grossly within normal. Foramen magnum is unremarkable. Degenerative changes at C3-C4 results in mild central spinal stenosis. No evidence of a spinal canal compromise or stenosis at any other level. Suboptimal quality of exam precludes precise assessment for the neural foramina. There is no detectable. Spinal soft tissue abnormalities.Nonenhanced thoracic MRI:This examination is also suboptimal due to excessive motion artifact. Multiple MRI sequences were repeated however without significant improvement.Within this limitation there is no detectable signal abnormality or vertebral column and alignment of the spine remains beginning normal. There is no convincing evidence of spinal canal compromise or stenosis. Grossly unremarkable signal intensity and caliber of thoracic cord.Grossly unremarkable paraspinal soft tissues.Lumbosacral spine examination also is limited due to motion artifact. No gross signal abnormality of the vertebral column other than mild changes secondary to degenerative disease. No evidence of a spinal canal compromise or stenosis at any level.No definitive evidence of very poorly visualized conus or the cauda equina.No gross abnormality of the paraspinal soft tissues.
1.Nonenhanced brain MRI demonstrate no acute intracranial process. Cerebellar and vermian parenchymal volume loss without detectable associated signal abnormality of the parenchyma. Mild generalized prominence of supratentorial cortical sulci likely within normal range for patient's stated age and unremarkable exam otherwise.2.Suboptimal MRI of spine secondary to extensive motion artifact as detailed. Within this severe limitation examination demonstrate degenerative changes of cervical spine with resultant mild central spinal stenosis only at C3-C4 level. No spinal stenosis at any other level. No convincing evidence of cord caliber or signal abnormality. Grossly unremarkable signal intensity and the alignment of the vertebral column. No convincing evidence of paraspinal soft tissue abnormalities. 