Reason: Please do with CSF flow study, Chiari malformation, evaluate for changes History: neck pain, headache Please note that the susceptibility artifact from braces severely limits evaluation of anterior structures on gradient echo images.MRI brain:There are postsurgical changes of suboccipital decompression and resection of the posterior arch of C1 with interval improvement of CSF spaces at the foramen magnum ventrally and dorsally. The tonsils extend to the upper margin of C1. CSF flow demonstrates brisk biphasic flow anteriorly. Mildly diminished flow posteriorly is noted which may be technical. Dorsal cerebellar surface is noted to abut the posterior dural margin which may suggest scarring.There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma appears unremarkable. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. Evaluation of the orbits and paranasal sinuses is limited due to artifact.MRI cervical spine:Postsurgical changes of suboccipital decompression as above. Vertebral body heights and discs are intact. Alignment is anatomic. Marrow signal is normal. No significant spinal or neural foraminal stenosis. No abnormal signal within the cord. No evidence of syrinx.
1.No recent comparison studies available. Compared to 2011, there has been interval suboccipital decompression of Chiari I malformation with improvement in CSF spaces and flow ventrally and dorsally at the neo foramen magnum. Dorsal cerebellum abuts the dural surface which may indicate some scarring.2.No evidence of syrinx in the cervical cord.