sb/hs/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzm B. Ganglmn / M / 43 yrs.
Referred by : Dr. Abc Xyzhari.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neck pain with weakness and numbness in all four extremities and gait imbalance since 3 months.

EXAMINATION :

M.R.I of the cervical spine was performed using the following parameters :

4 mm thick T1 Weighted and T2 Weighted sagittal images.
3 mm thick T1 Weighted and Fast Scan (T2 *) axial images.
3 mm thick T1 Weighted coronal images.

OBSERVATION :

There is loss of water content of the cervical intervertebral discs.

There is seen a dumb-bell shaped lesion in the cervical spinal canal on the right extending over the C4 and C5 vertebral levels and extending out into the right paravertebral region through the right neural foramen at the C4-C5 level. This lesion is predominantly iso to hypointense when compared to the normal cord on the T1 Weighted images and appears hyperintense on the T2 Weighted and Fast Scan (T2 *) images. This lesion is most likely intradural and extramedullary in location. There is cord compression and displacement of the cord to the left over the C4 to C6 vertebral levels. The cervical spinal cord at these levels shows a hyperintense signal on the Fast Scan (T2 *) images suggesting cord edema/ischemia. Erosion of the right lateral margin of the C5 vertebral body is noted. The right vertebral artery at this level is displaced anteriorly.

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Small postero-central protruded discs are noted at the C2-C3 and C3-C4 levels.

A small posterior disc herniation with peridiscal osteophytes is noted at the C5-C6 level.

A right paracentral disc herniation with peridiscal osteophytes is noted at the C6-C7 level.

Degenerative changes of the joints of Luschka are noted at the C5-C6 level bilaterally and facetal hypertrophy is noted on the left at the C3-C4, C4-C5 and C5-C6 levels.

The rest of the cervical vertebral bodies show normal signal intensity. The visualized prevertebral soft tissues are unremarkable.

The atlanto-axial region and the cervico-medullary junction are unremarkable.

IMPRESSION :

1. An intradural and extramedullary dumb-bell shaped lesion extending over the C4 and C5 vertebral levels with cord compression as described represents a nerve sheath tumor. Cord signal alteration may suggest cord edema/ischemia.

2. Small postero-central protruded discs at the C2-C3 and C3-C4 levels.
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3. A small posterior disc herniation with peridiscal osteophytes at the C5-C6 level.

4. A right paracentral disc herniation with peridiscal osteophytes at the C6-C7 level.

5. Degenerative changes of the joints of Luschka at the C5-C6 level bilaterally and facetal hypertrophy on the left at the C3-C4, C4-C5 and C5-C6 levels.