Findings:
Head:
Minimal left subdural fluid collection with hyperintense signal on T1-weighted and on T2-weighted images and diffusion restriction is seen overlaying the left cerebral hemisphere, in keeping with a subacute subdural haemorrhage. No associated mass effect, no midline shift.
Possible small foci of extra-axial/subdural haemorrhage are also noted in the right frontoparietal region.
Multiple FLAIR/T2 hyperintense foci are seen in bilateral cerebral white matter, in keeping with mild small vessel ischaemic disease. The brain parenchyma is otherwise unremarkable without evidence of any recent ischaemic event or intra-axial haemorrhage.
The ventricles and sulcal spaces are within normal limits.
Minimal mucosal thickening is seen in the paranasal sinuses bilaterally. The mastoid air cells are clear. No bony abnormality is seen.
Spine:
The craniocervical junction is normal. The cord is unremarkable without evidence of demyelinating lesions or myelopathy.
There is thin extradural fluid collection starting at C6/7 mainly posteriorly and extending at least to T12 level. No cord compression or spinal canal stenosis.
Previous hemilaminotomy at T5 – T7.
A right paramedian disc protrusion is seen at T7/8 without any relevant stenosis.
Minimal disc bulging is seen at L4/5.
Known bilateral spondylolysis at L5/S1 with intervertebral osteochondrosis, disc degeneration and protrusion and bilateral osteoarthritis of the facet joints without any high-grade stenosis.
No paravertebral lifestyle abnormality.
Conclusion:
Features suggestive of CSF leakage with extradural fluid collection posterior to the spinal cord at C6/7 to T12 levels and minimal bilateral subacute subdural haemorrhage. No mass effect, no cord compression. Neurosurgical referral is advised.