Female, 12 years old, with rapidly changing scoliosis, headaches and syncopal events. Evaluate for Chiari malformation, syringohydromyelia, and tethered cord. Brain:Brain parenchymal morphology is within normal limits. No evidence of Chiari malformation or any other structural abnormality is seen. No parenchymal signal abnormality, edema or mass effect is observed. No intracranial hemorrhage or any abnormal extra axial fluid collection is seen. The pineal gland is slightly prominent though it measures less than 1 cm in diameter and if anything this simply represents a benign pineal region cyst. The left lateral ventricle is slightly larger than the right, but this is within the limits of normal variation.Spine:A scoliotic curvature of the spine is seen, though this is better assessed on prior radiographs. The sagittal alignment of the spine is otherwise unremarkable. A normal complement of vertebral bodies is present. Vertebral body morphology and signal characteristics are within normal limits. The intervertebral discs are preserved. No spinal canal or foraminal stenosis is detected.The spinal cord demonstrates normal signal intensity and morphology. The conus tip terminates at the L1 level which is normal. The nerve roots of the cauda equina disperse evenly through the thecal sac. No fatty filum terminale or other intraspinal fatty lesion is seen. No epidural abnormality is suspected. On prone imaging, there is anterior displacement of the conus and cauda equina.
1.Unremarkable evaluation of the brain. At most there may be a mild pineal region cyst which requires no specific follow-up.2.Apart from scoliosis, unremarkable evaluation of the spine. No evidence of Chiari malformation, syringohydromyelia or tethered cord.