Name of the Patient : Abc Xyzlmn / F / 65 yrs.
Referred by : Dr. Abc Xyzharma / Dr. Abc Xyzah.
Examination : M.R.I. of the Cervical Spine.
CLINICAL PROFILE :
C/O inability to sit and stand since 8 days with irrelevant talk.
H/O right hemiplegia 32 years ago.
M.R.I of the cervical spine was performed using the following parameters :
4 mm thick T1 Weighted and T2 Weighted sagittal images.
5 mm thick T1 Weighted and Fast Scan (T2 *) axial images.
There is reversal of normal cervical lordotic curve.
There is occipitalization of the atlas with the tip of the odontoid process seen to lie at the foramen magnum level.
There is ligamentum flavum hypertrophy at the C2 level on the left side with compression and displacement of the spinal cord to the right. The spinal cord appears to be of slightly smaller in calibre over these levels.
The cervical spinal cord over the C1-C2 to the C4-C5 level shows hyperintense signal on the T2 Weighted and Fast Scan (T2 *) images. This is isointense to hypointense to cord on the T1 Weighted images suggestive of cord gliosis/edema/ischemia.
Small posterior disc herniations with peridiscal osteophytes are seen at the C2-C3, C3-C4 and C4-C5 levels with anterior indentation of the cord.
The joints of Luschka at the C3-C4 and C4-C5 levels show degenerative changes bilaterally.
There is a large osteophyte arising from the superior aspect of the C3 vertebral body with antero-lateral compression of the cord and the left C2 nerve root. Another similar osteophyte is seen at the C4 level.
Fatty changes are noted in the cervical vertebral bodies.
The cervical intervertebral discs show loss of water content. The remaining joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.
The brain was screened with 5 mm thick T2 Weighted axial images which shows subtle hyperintense areas in the periventricular deep white matter and are probably ischemic in etiology.
Old infarcts are seen in the head of the caudate nuclei bilaterally. There is mild dilatation of the ventricular system with prominence of the cerebral cortical sulci and cerebellar folia bilaterally.
1. Occipitalization of the atlas with the tip of the odontoid process lying at the foramen magnum level.
2. Altered cord signal over the C1-C2 to the C4-C5 levels is suggestive of cord gliosis/edema/ischemia.
3. Small posterior disc herniations with peridiscal osteophytes at the C2-C3, C3-C4 and C4-C5 levels with large osteophytes at the C3 and C4 levels.