11-year-old female with history of medulloblastoma. Status post craniotomy, radiotherapy and chemotherapy. Off treatment. Now has neck pain and altered mental status. Brain: This study is mildly limited by artifact related to dental hardware. Findings related to prior surgery and treatment within the posterior fossa are significantly changed. The tumor resection bed, and associated encephalomalacia of the cerebellar hemispheres, are stable in appearance. A small area of enhancement measuring 6 x 4 mm along the right margin of the fourth ventricle is unchanged. There is no new suspicious enhancement.Elsewhere in the brain, encephalomalacia affecting the right occipital lobe is unchanged and there are no new foci of pathologic enhancement. The numerous foci of susceptibility artifact within the brain parenchyma and along the ventricular margins are not significantly changed. Ventricles are minimally larger than they were on the previous examination. Spine: Spinal cord morphology and signal characteristics are within normal limits. There is no pathologic intrathecal contrast enhancement but the cervical spine is partially obscured by artifact on the postcontrast images.Fatty marrow replacement at some levels of the spine is compatible with prior radiation therapy. There is no suspicious marrow signal abnormality, otherwise.Spinal alignment is anatomic, coming for cervical and lumbar straightening which can be related to patient position. Vertebral body heights and morphology are within normal limits. There is no spinal canal or neuroforaminal stenosis.
1.The posttreatment findings in the posterior fossa remain unchanged without sign of local recurrence. Minimal contrast enhancement along the right lateral fourth ventricular wall is unchanged since May 2014.2.Other findings throughout the brain also remain unchanged without suspicion of recurrence.3.Spinal imaging is notable for radiation treatment findings in the marrow but no sign of metastasis is seen. 