Chiari malformation. Brain: There are postoperative findings related to Chiari decompression with an unchanged extradural fluid collection at the surgical bed, measuring up to 6 mm in thickness. There is mild deformity of the posterior inferior cerebellum and medulla associated with what appear to be linear hypointense band that extend to the overlying dura. There is CSF flow across the anterior foramen magnum, but cerebrospinal fluid flow appears to be relatively deficient posteriorly. There is no evidence of acute intracranial hemorrhage, mass, or acute infarct. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. Cervical Spine: There are postoperative findings related to Chiari decompression. There is no evidence of syringohydromyelia. However, there area a few punctate foci of susceptibility effect in the spinal cord at the C2 and C3 levels, which may represent chronic blood products. The vertebral body heights are preserved. There is no significant spinal canal or neural foraminal stenosis. The vertebral bone marrow signal is unremarkable. The vertebral column alignment is unchanged with mild retroflexion of the dens and lack of the usual lordosis. There appears to be a left thyroid nodule.
1. Postoperative findings related to Chiari decompression with a persistent small pseudomeningocele and mild deformity of the posterior inferior cerebellum and medulla that may be related to adhesion formation2. Apparent punctate chronic blood products in the spinal cord at the C2 and C3 levels, but no evidence of syringohydromyelia.3. Apparent left thyroid nodule, which is incompletely characterized. A thyroid ultrasound may be useful for further evaluation.