67-year-old male with C6 spinal ependymoma, status post resection and radiation therapy. Weakness and paresthesias. Evaluate for progression. Again seen are postsurgical changes in the cervical spine from C4 to C6 related to myelotomy and resection of intramedullary lesion extending from the upper C5 to the C6-C7 levels. There is decrease in T2 hyperintensity compatible with evolution of surgical resection cavity. Hemosiderin staining involving the cord and volume loss is again seen. Areas of T1 hyperintensity and mild ill-defined enhancement again seen. No new or enlarging mass to suggest tumor progression are appreciated. Previously seen extradural fluid collection along the surgical tract has resolved.Degenerative changes are again seen including a central disc protrusion which indents the ventral cord at the C3-C4 level which appears similar to prior. There is moderate spinal canal and moderate bilateral neural foraminal stenosis at this level. There is also moderate spinal canal stenosis at C4-C5 related to small disc protrusion and ligamentum flavum thickening as well as moderate left and mild to moderate right neural foraminal stenosis at this level. These findings are unchanged. Mild C5-C6 disc bulge is also unchanged.
1. Compared to 4/20/2015, there has been evolution of postsurgical changes of resection of hemorrhagic intramedullary mass with interval decrease in size of resection cavity and resolution of previously seen extradural fluid collection. No findings to suggest tumor progression.2. Unchanged degenerative changes including disc protrusion at the C3-C4 level with mild cord flattening. No associated cord signal abnormality. There is also moderate bilateral neural foraminal stenosis at this level.