Female, 10 years old, with Chiari malformation and spinal cord syrinx, evaluate for changes, three-month follow-up. Evidence of suboccipital craniectomy and resection of the posterior arch of C1 is demonstrated for Chiari decompression. Superficial to the duraplasty, there is a fluid collection which follows the signal of CSF measuring up to 14 mm in thickness, 33 mm in length and 20 mm in width, compatible with a pseudomeningocele.Relative to the preoperative examination, the CSF space at the level of the foramen magnum has been significantly expanded. Robust biphasic CSF flow is seen through the anterior aspect of the foramen magnum. Mild but distinct biphasic CSF flow is seen through the posterior foramen magnum, around the tonsils and through the foramen of Magendie. The previously seen spinal cord syrinx has significantly decreased in size, now measuring no more than 1 mm diameter, previously 3 mm. This minimal residual prominence of the central canal of the cord begins at approximately C5 and continues down to T8.Spinal alignment is anatomic. Vertebral body height and morphology are within normal limits. No marrow replacement or marrow edema is detected. No significant compromise of the spinal canal or neural foramina is seen.
1.Findings are seen compatible with interval Chiari decompression including suboccipital craniectomy and resection of the posterior arch of C1. Just superficial to the duraplasty, there is a fluid collection measuring up to 14 mm in thickness compatible with a pseudomeningocele.2.Relative to the preoperative examination, the CSF space at the foramen magnum has been significantly expanded. Robust biphasic CSF flow is seen through the anterior aspect of the foramen, with mild but distinct biphasic flow posteriorly, along the tonsils and through the foramen of Magendie.3.A significant decrease in the size of the spinal cord syrinx is also demonstrated.