Dandy-Walker variant. Colloid cyst, treated. Low-lying conus medullaris. Prone imaging was not performed. The anesthesia team recommended against performing prone imaging given the small size of this tracheostomy.Brain:Hypoplastic inferior cerebellar vermis, rotation of the superior cerebellar vermis and mild elevation of the torcular herophili are compatible Dandy-Walker spectrum/continuum. Mild lateral and third ventricular dilatation is unchanged. There is no sign of recurrence of the colloid cyst in the third ventricle. T2-hyperintensity in the parietal deep white-matter may represent terminal zones of myelination.Few foci of susceptibility effect along the brain surface and the ventricular lining are more prominent than on the previous examination. This may relate to improved sensitivity of the examination or to increased cerebral hemosiderosis. There is also hemosiderin staining along the surgical tract in the right frontal lobe. A prominent vessel in the left occipital lobe may represent a developmental venous anomaly and was present previously. There is no midline shift or brain herniation. Major intracranial vascular flow voids are preserved.There is fluid in the right mastoid air cells. There is minimal ethmoid mucosal thickening which is nonspecific. The adenoids are enlarged but this is a common finding in this age group.Whole Spine:The vertebral column alignment is within normal limits. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is unremarkable. There is no significant spinal canal stenosis. The spinal cord displays normal signal and morphology. The conus medullaris tip lies at the lower L3 level which is unchanged. There is no evidence of filum terminale fibrolipoma and the cauda equina nerve roots are unremarkable. There is no malignancy seen. There is no fistulous tract in the subcutaneous tissues over the sacrum and lower lumbar spine. Other findings including agenesis of the left kidney, tracheostomy and a gastrostomy tube only partially included. The rectum is distended with stool.
1.Dandy-Walker spectrum/continuum findings as described above.2.Unchanged mild dilatation of the third and lateral ventricles.3.Cerebral hemosiderosis may have slightly increased since the previous examination.4.Unremarkable spine apart from low-lying conus medullaris which is unchanged. As discussed above, sagittal imaging was not performed in the prone position because of the small size of the tracheostomy, per the recommendation of the anesthesia team.