Chiari decompression with new and worsening headaches and neck pain. Brain: There has been interval Chiari decompression surgery. There is tenting of the posteroinferior cerebellum to the overlying dura associated with intervening hypointense bands. There is also blunted CSF flow across the posterior aspect of the neo-foramen magnum. Otherwise, there is intact CSF flow across the anterior neo-foramen magnum and the cerebellum extends to the level of tip of the dens inferiorly. There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma and pituitary gland appear unremarkable. The ventricles are normal in size and configuration. There is no midline shift. The major cerebral flow voids are intact. The orbits and paranasal sinuses are grossly unremarkable.Cervical Spine: The spinal cord displays normal signal and morphology, without evidence of syrinx. The vertebral column alignment is unchanged. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is unremarkable. There is no significant spinal canal stenosis.
1. Interval Chiari decompression surgery with evidence of arachnoid adhesion formation along the posteroinferior cerebellum.2. No evidence of syringohydromyelia in the cervical spinal cord.