Biopsy-proven idiopathic hypertrophic pachymeningitis Again seen is a retroclival mass extends inferiorly through the craniocervical junction to the C1 level. There is no significant change in size compared to 5/30/2015. Mass measures approximately 13 mm in thickness at the level of the medulla similar to prior with near complete effacement of the premedullary cistern. The craniocaudal extent measures approximately 5.4 cm and extends from the dorsum sella to the upper C2 level. No significant change allowing for differences in scanning technique and head position. Also noted is dural based thickening T1-T3 levels which is partially imaged and was present previously.The cervical vertebral bodies are appropriate in height. Alignment is unchanged including mildly exaggerated cervical lordosis, mild retrolisthesis of C4 on C5, and mild anterolisthesis of T2 on T3. Postsurgical changes of posterior spinal fusion are again seen with hardware including lateral mass screws at C3, C4, and C5 and paraspinous rods which extend inferiorly into the upper thoracic spine outside the field-of-view. Hardware may be better assessed by radiographs or CT. Bone marrow signal is within normal limits. The cervical spinal cord has grossly normal signal characteristics and overall morphology with artifact related to susceptibility slightly limiting evaluation. There is mild spinal canal stenosis at the C4-C5 level similar to prior. There is otherwise no significant spinal canal or neural foraminal stenosis in the remainder of the cervical spine. Paraspinous soft tissues aside from postsurgical changes are unremarkable.
Compared to 5/30/2015, there is no significant change in enhancing dural-based retroclival mass which extends from the dorsum sella to the craniocervical junction and effaces the premedullary cistern. Dorsal dural based enhancement involving the upper thoracic spine is again seen and partially imaged.