85 year-old male with fall and loss of consciousness. CT of brain without infusion.Large vessel intracondylar vascular calcification is noted.No evidence of hemorrhage, edema, mass-effect, midline shift or hydrocephalus. Patchy areas of periventricular lucencies are concerning for small vessel disease considering patient's age. Small area of cortical encephalomalacia in the high convexity left parietal is believed to represent an old small cortical stroke. No evidence of post traumatic findings. Calvarium, paranasal sinuses and mastoid air cells are unremarkable.CT of the cervical spine.Extensive degenerative changes of the cervical spine with significant loss of intervertebral disk height at multiple levels are noted. The alignment of cervical spine remains within normal limits. The facets are aligned and demonstrate no subluxation. A linear defect bilaterally across the pedicles of C6 is noted. There is however no evidence of any malalignment of these pedicles. Considering the patient's history I cannot entirely rule out nondisplaced bilateral pedicular fracture.These findings are best appreciated on sagittal image 15 for the right pedicle of C6 and sagittal images 24 and 25 for the left. Both of these findings are also appreciated on axial images 41 and 42. Follow-up with a repeat thin cuts CT and or an MRI is recommended.Dr. Watts from the emergency service was notified of the findings at the time of interpretation.
1.Unremarkable CT of brain without infusion.2.Suspected bilateral C6 pedicular fracture as detailed.3.Extensive degenerative changes of cervical spine.4.No malalignment of the cervical spine.