Chiari surgery with pseudomeningocele: headache and neck pain. Brain: There are interval postoperative findings related suboccipital craniotomy. There is a persistent focus of nodular enhancement along the posterior aspect of the inferior medulla that measures up to 8 mm. There is a left transfrontal catheter that terminates in the atrium of the left lateral ventricle and a right transparietal catheter that terminates in the right anterior parafalcine region. The ventricles are unchanged in size and configuration. There is unchanged encephalomalacia in the right posterior frontal and parietal lobes. There is no evidence of acute infarction. There is colpocephaly with dysgenesis and thinning of the corpus callosum. There is unchanged beaking of the tectum and prominence of the mass intermedia. The fourth ventricle remains partially effaced, with paucity of choroid plexus tissue. There is mild distortion of the posterior cerebellum and medulla, which may be related to adhesion formation. The CSF flow study demonstrates biphasic flow anteriorly at the level of the foramen magnum, but relative paucity of flow posteriorly.Cervical Spine: There is mild prominence of the central canal at the level of the dens, measuring 1 to 2 mm in width. There are minimal posterior disc-osteophyte complexes at multiple levels without significant spinal canal stenosis. The vertebral column alignment is anatomic. The vertebral bone marrow signal is unremarkable. The vertebral body heights are intact.
1. Interval postoperative findings related to inferior cerebellar biopsy with a persistent subcentimeter lesion along the posterior aspect of the medulla, which likely represents ectopic choroid plexus.2. Unchanged intracranial stigmata of Chiari II malformation and the shunted ventricular system. 3. Minimal syringohydromyelia in the upper cervical spinal cord.4. Suggestion of arachnoid adhesion formation in the suboccipital surgical bed, but no evidence of pseudomeningocele.