[leedabird]

#35384

Hello Dr. Corenman,

I am so thankful to have found your website! It looks like a wealth of resources that I look forward to digging into soon. Looking for any insight into some symptoms and my MRI results. I’ll try to be as concise as possible.

Traumatic Cervical Injury-6 years old (1990?)

Cervical disc herniation w/corticosteroid injection in college followed by chiropractic care for years for pain management (2005?)

In addition to chronic cervical pain & fatigue, the last year or so I have developed some slowly progressive symptoms, such as bilateral muscle weakness in my arms and legs, pulling sensations in my hands and feet (sometimes very painful), eye strain/blurry vision (ophthalmology work up negative), fullness in my ears, migraines, & dizziness. All symptoms are intermittent in severity & presence except the neck pain/pressure and ear fullness are constant.

A month ago I developed severe shortness of breath at rest (no hypoxia) and slight tachycardia (120-130 bpm). Lasted 4 days. ER visit negative for any known cause. Outpatient cardiac testing negative. Still have underlying shortness of breath with exertion but not to the extreme of those 4 days. CT head only showed a right 6mm cerebellar tonsillar ectopia. Awaiting neurology follow up in the mean time. MRI Cervical/Thoracic Spine results:

MRI CERVICAL SPINE W WO CONTRAST, MRI THORACIC SPINE W WO CONTRAST

CLINICAL INFORMATION: 38 years-old Female, Motor neuron disease.

COMPARISONS: None.

TECHNIQUE:
Multiplanar, multisequence, MR imaging of the cervical and thoracic spine
without and with contrast was acquired.

CONTRAST: 7 mL Gadavist

FINDINGS:
Cervical spine:
Craniocervical alignment preserved. Straightening of the usual mid cervical
lordosis. No abnormal spondylolisthesis. Vertebral body heights are
preserved. Minimal marrow edema along the C7 superior endplate is likely
degenerative in nature. A small area of marrow STIR hyperintensity at the
left pedicle/facet junction also has intrinsic T1 hyperintensity, most
likely a benign hemangioma. No significant paraspinal soft tissue
abnormality. No abnormal epidural fluid collection. The cervical spinal
cord is normal in caliber and signal intensity. Degenerative changes are
detailed by level below.

Segmental analysis:
C2-C3: Unremarkable.

C3-C4: Unremarkable.

C4-C5: Mild left uncovertebral hypertrophy and small leftward disc
osteophyte complex blending with uncovertebral hypertrophy resulting in
mild left foraminal narrowing.

C5-C6: Minimal uncovertebral hypertrophy, minimal disc height loss, and
small disc osteophyte complex result in ventral cord contour flattening but
no significant spinal canal narrowing.

C6-C7: Minimal ligamentum flavum infolding and small disc osteophyte
complex with mild spinal canal narrowing.

C7-T1: Unremarkable.

Other findings: There is 6 mm right cerebellar tonsillar ectopia without
significant left cerebellar tonsillar ectopia, pointed configuration of the
right cerebellar tonsil, or substantial foramen magnum crowding. This is
most likely incidental.

Thoracic spine:
Mildly exaggerated upper thoracic kyphosis. Minimal anterolisthesis of T2
on T3 Mild thoracic dextroconvex curvature with apex at T7-T8. Vertebral
body heights are preserved. Small foci of marrow STIR hyperintensity within
the T7 and T8 vertebral bodies have signal dropout on out of phase gradient
in phase imaging, likely small hemangiomas with atypical signal features.
Paraspinal soft tissues are without significant abnormality. No abnormal
epidural fluid collection. The thoracic spinal cord is normal in caliber
and signal intensity, accounting for mild intermittent artifact.

There is mild thoracic facet arthropathy primarily at the upper levels on
the right. There is mild leftward disc height loss at T6-T7 and T7-T8
primarily due to curvature effects. There are small anterior projecting
endplate osteophytes at upper and mid thoracic levels but there are no
significant disc bulges, protrusions, or extrusions. The spinal canal is
patent without significant stenosis. Foraminal narrowing is minimal on the
right at T2-T3.

Degenerative changes of the low lumbar spine are incompletely evaluated on
all spine images obtained for localization purposes.

IMPRESSION:
1. No cervical or thoracic spinal cord lesions.
2. Degenerative changes of the cervical spine as detailed by level in the
body of this report. Spinal canal narrowing is mild at C6-C7 and foraminal
narrowing is mild on the left at C4-C5.
3. Mild thoracic spine facet arthropathy and mild anterior endplate
osteophytes without disc bulge, protrusion, or extrusion. Foraminal
narrowing is minimal on the right at T2-T3 and there is no significant
spinal canal narrowing.
4. Mild right cerebellar tonsillar ectopia, likely incidental.

Thank you so much for your professional opinion!!

Lydia

[leedabird]

#35385

I also have daily urinary frequency and intermittent (rare) sciatic like pain shooting down my leg if that’s helpful information.

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