 Images are slightly limited by patient motion. Again seen are postoperative findings from previous Chiari decompression and fourth ventricular stenting. The stent appears in stable position, with the cranial tip extending through to the upper cerebral aqueduct. Ample CSF space is seen at the distal end. The cerebellum is unchanged in appearance, with a patent neo-foramen magnum. CSF flow imaging demonstrates prominent ventral flow along the brainstem and upper cervical cord. There is redemonstration of biphasic flow along the dorsal aspect of the neo-foramen magnum and upper cervical spinal canal, although the anterior superior extent is not as well delineated as on prior exam, although this is possibly artifactual.The ventricles and sulci are within normal limits. The basal cisterns remain patent. There is no midline shift or mass effect. There is no diffusion abnormality. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major intracranial vascular structures. There is redemonstration of a stable 5 mm nodule along the superior aspect of the pituitary gland. The remainder of the midline structures and craniocervical junction are within normal limits. Postoperative changes are seen from anterior cervical discectomy and fusion a C6-C7. Instrumentation is suboptimally evaluated on MRI. The cervical spine is in normal alignment, with a normal cervical lordosis. The vertebral body and disk heights are stable. No worrisome focal marrow signal abnormality is appreciated. The spinal cord is of normal caliber and signal.Mild spondylosis at the C5-C6 and C6-C7 levels is unchanged, with minimal effacement of the ventral CSF space at the C5-C6 level related to minimal disc bulge and trace ligamentum flavum thickening.
1. Stable exam, with redemonstration of postoperative changes from previous Chiari decompression and fourth ventricular stenting. Patent neoforamen magnum without significant interval change in CSF flow appearance.2. Stable small rounded nodule along the superior aspect of the pituitary gland.