24 years Female (DOB:6/6/1991)Reason: hx Chiari malformation and known cervical syrinx. Eval for changes, eval spine for syrinx length, History: headachesPROVIDER/ATTENDING NAME: EDWIN RAMOS EDWIN RAMOS Cervical spine:The cervical vertebral bodies are appropriate in overall alignment and height. The cerebellar tonsils are pointed inferiorly and extend 5 mm below the level of the foramen magnum.There is basilar invagination present associated with at least partial atlanto-occipital assimilation. The odontoid extends 12mm above Chamberlain's line and 15mm above McGregor's line. The C2-C3 disk space is small. The CSF space is effaced at the level of the foramen magnum and the cervicomedullary junction is deformed. The clivus is foreshortened.There redemonstration of a syrinx extending from C5 inferiorly into the thoracic spine.At C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there is no significant compromise to the spinal canal or neural foramina. There is a disk bulge associated with mild disk dessication at this level.At C4-5 there is no significant compromise to the spinal canal or neural foramina.At C5-6 there is no significant compromise to the spinal canal or neural foramina. There is a very small right paramedian disk protrusion at this level.At C6-7 there is no significant compromise to the spinal canal or neural foramina. There is a small right paramedian disk protrusion at this level.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact. The left vertebral artery is very small relative to the right vertebral artery.MRI thoracic spine:There is a syrinx present extending from the C5 level to the T6-7 disk space level. Its maximum diameter is 2x5mm at the T4 vertebral level. There is a levocurvature to the thoracic spine.The thoracic vertebral bodies are appropriate in the overall alignment and height. There is no compromise of thoracic spinal canal or exiting nerve roots. Lumbar spine:Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall alignment and height. The conus medullaris on sagittal imaging is grossly intact.There is a compensatory dextrocurvature to the lumbar spine.At L5-S1 there is no significant compromise to spinal canal or neural foramina.At L4-5 there is no significant compromise to spinal canal or neural foramina.At L3-4 there is no significant compromise to spinal canal or neural foramina.At L2-3 there is no significant compromise to spinal canal or neural foramina.At L1-2 there is no significant compromise to spinal canal or neural foramina.
1.Basilar invagination associated with suspected atlanto-occipital assimilation. CT of the cervical spine may be of further benefit in evaluating this. There is associated stenosis at the level of the foramen magnum with deformation of the cervicomedullary junction.2.The cerebellar tonsils are low lying (likely as a result of basilar invagination) giving a Chiari I malformation.3.Spinal cord syrinx extending from the mid-cervical to the mid-thoracic spine. Although the portions visualized on the prior exam appear stable compared to the current, There is no comparison thoracic spine MRI to assess progression.4.Sigmoid curvature to the thoraco-lumbar spine.5.The LVA appears hypoplastic.6.Mild degenerative changes are present in the cervical spine.