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I was wondering if I should be concerned? this is my MRI report , do this indicate if I have any lessions?

The Brain parenchymn is within normal limits in signal intensity.There is no evidence of deymelination or infarction.There is no hydrocephalus.No Abnormal increased susceptibilty is seen in the brain parenchyma on the gradient echo sequence.No acute abnormality is noted on diffusion weighted imaging. The visualized intracrancial flow voids are within normal limits in appearance.

The piturary gland appears a bit bulky and mildly heterogenous in signal on T1 and T2 .It is measured 8mm suoerior inferiorly and appears stable compared to the previous study.these findings are non specific.
There is musosel thickening in the etmoid and maxillary sinuses.

Impression

The Brain is within normal limits in apperanace but there is no evidence of deyelimation.

The pituary gland appears bulky and mildly heterogenous. I note that the pituary gland does measure up to 9mm to 10mm superior inferiorly on the sagittal cervical spine images. This could be performed with contrast . I note the patient has a history of an adrendal malignancy and therefore post contrast images would be helpful to most confidently exclude intracranial metastic diease.

Thank you very much

Greetings,
I am new to this forum but have been observing it a lot ever since my spinal cord injury that just took place about a month ago. I sustained two gun shots 1 to my Arm and 1 to my back, while getting shot the force or maybe the shock since it was a close distance shooting led me to fall face first on the pavement thus fracturing the cervical part of the spinal cord (Neck). The CT scan of the neck showed a comminuted fracture of the posterior right C4 facet, in addition there are hairline fractures of the right lamina C5 and Comminuted fractures of the spinous processes of C7 to T3. I was given a Aspen Collar and told to keep it on for 6 weeks, i have now had it on for 4, at the start of my injury i had a lot of burning sensation and pain in my hand and several muscle cramps that would make my hand so stiff and it only goes away when i wiggle my fingers then it feels as if a little rush of blood or something runs through the hand making it less tense until it happens again very shortly, this pain seems unbearable at some points. The pain had reduced a little bit as the weeks went by but i could still feel it even while i was on percocets (pain killers) i cant use my hand as i could before this being my right hand (my dominant hand)and me being a top prospect in the country for basketball has me feeling very distraught and sad, i just wonder if my hand will ever go back to being normal and functioning fully as it once did? I am supposed to go for a MRI test sometime this week for the right bracheal plexus to show what was damaged inside. Im also wondering why this pain is so strong in my hand and why it hasnt really gone away even after a month, keep in mind i also had a clot in the auxillery vein however the ultrasound showed that the blood was flowing so they okay’d it. Im 19 years old and just extremely worried as a normal human would, what can i do to reduce the pain? I also wonder will my neck be able to turn side to side as i once did or will the turning be reduced slightly? Also my shoulder doesn’t seem to rotate fully as much as my left shoulder does but im assuming that also stems from the injury to the spine or maybe the discomfort of the aspen collar on my shoulders or neck muscles. Your help is greatly appreciated, and any input is very beneficial.

Thanks for reading.

As many others have said, thank you for this comprehensive web site for patients to explore and learn.

I am a 52 yo male in good health and fitness. Recently widowed and raising a 12yo.

In the Spring of 2009 I was struggling with sciatica on my right side. An x-ray report had the following findings: Grade 1 retrolisthesis of L4 relative to L5 and possible bilateral spondylolysis. Nocompression fracture. Miminal marginal osteophytes at L2-L5.

Not long after that report, my sciatica vanished. Life resumed.

Fast forward to Christmas 2011. I wrench my back by lifting improperly and get terrible lower back pain, mostly on the left. I commence PT, and by March of 2012 the back pain is gone. But I have residual tingling and numbness in my left inner thigh and above my left groin. Also, a numb spot develops on the bottom of my left foot below the middle toes.

June 2012: I see a neurologist who does a nerve test and says I have slightly diminished function on my left side. He orders an MRI with the following findings: Grade 1 anterolisthesis of L4 on L5 of 6mm. No compression fractures. No suggestion of metastaic disease. There are questionable L4 lysis deformities. There is minimal L4-L5 disc space narrowing and decrease in L3-L5 disc space signal characteristics. Conus ends normally.
L1-L2: Minimal disc bulge, no central stenosis. Far left lateral disc herniation with mild narrowing of the far lateral aspect of the left foramen abutting the exiting L1 root.
L2-L3: No disc herniations, the foramen are patent.
L3-L4: Disc bulge with mild sac compression, no central stenosis and mild bilateral foramina narrowing. Mild bilateral facet degenerative changes.
L4-L5: Severe central stenosis due to a pseudo-disc bulge and ligamentum flavum and facet hypertophic changes. There is moderate to severe left and right foramina narrowing likely compressing the exiting L4 nerve roots. In the far lateral aspect of the right foramen extending into the soft tissues, there is a 1.1 cm x 5 mm T2 hyper intense structure that is likely fluid, possibly related to compression of a usually prominent dural nerve root sleeve. Along the posterior aspect of the left facet complex, there is a 6 mm synovial cyst.
L5-S1: Mild bilateral facet degenerative changes.
But despite the report, I’m doing really well. I hiked the Rockies for the first time in July with no problems.

Fall 2012: Sciatica on my right side returns. If I try to power through the sciatica, it feels like a knife in my groin. Sitting or squatting usually resolves the pain allowing me to continue walking or standing. A series of epidural steroid injections provide only a day or two of relief. On the left side, the numbness and tingling continues on the inner thigh. Numbness at bottom of left foot increases slightly. I continue doing the PT exercises I learned at start of year. No back pain, can sit and sleep comfortably

Winter 2013: I am increasingly home bound. Cannot stand or walk for more than 5-15 minutes. I begin to interview spine surgeons. More epidurals, but no lasting relief. NSAID therapy likewise does nothing. I begin swimming laps at the public pool, it gets me fit but no relief for the sciatica. Continue with PT exercises. Still no back pain, can sit and sleep very comfortably.

April 2013: I have seen both an orthopedic surgeon and a neurosurgeon. Both say I need a laminectomy and level 1 fusion at L4-L5. Both say there is no hurry to decide. The neuro wants to go in with MIS from the side with one set of screws, the ortho wants open me up from the back with two sets of screws. Again, l have no back pain, can sit and sleep very comfortably.

Question 1) In my MRI report I am unable to understand if the facet joints are causing the problem. Is the “synovial cyst” the indicator of degeneration? If it could be drained and shrunk, could that improve my condition?
Question 2) I feel no instability, and can rotate and bend backwards with no instant pain. The report indicates minimal disc space narrowing. A flexion X-ray confirms the level 1 spondy. I assume the pseudo disc bulge is a major player here. Is that bulge why fusion is recommended?
Question 3) Do I go minimally with the neuro or the old fashioned way with the ortho. I liked both, and both came recommended from other docs.
Question 4) Should I do this sooner rather than later for best results?

My Oswestry score is 28 which seems pretty low in the scheme of things. As a single dad to a minor, I am loathe to have such a serious surgery, but my quality of life is diminished due to my inability to stand or walk for extended periods.

I know I’ve posted a lot of info. Thanks you.