30 year old female patient with Chiari malformation with decreased CSF flow, preoperative MRI for surgery . BRAIN: There is artifact from the patient's shunt apparatus which mildly obscures visualization of the right occipital lobe and posterior fossa. Within this limitation, there is no evidence of intracranial hemorrhage, mass, or acute infarct. There is stable curvilinear T2 hyperintensity traversing the right frontal lobe into the genu of the corpus callosum, which may represent Wallerian degeneration related to the shunt tract. There is unchanged punctate susceptibility in the pons and right middle cerebellar peduncle. The ventricles and basal cisterns are stable in size and configuration. There is no midline shift. The major cerebral flow voids are intact. There is minimal scattered paranasal sinus mucosal thickening. The orbits are grossly unremarkable.CERVICAL SPINE: There are post-surgical changes related to a Chiari decompression. The cerebellar tonsils are unchanged in appearance and position, with tenting of the inferior cerebellum towards the overlying dura. There is biphasic cerebrospinal fluid flow anteriorly through the neoforamen magnum with minimal flow posteriorly, which is similar to the prior study. There is a catheter is entering the spinal canal posterior at the level of the foramen magnum and coursing to the left lateral aspect of the thecal sac. There is no signal abnormality within the cervical or imaged upper thoracic spinal cord. There is no syrinx. The alignment of the cervical spine is unchanged. The vertebral body heights are maintained. There is no significant degenerative disc disease, spinal canal stenosis, or neural foraminal stenosis.
1. Post-surgical findings related to Chiari decompression with suggestion of adhesion formation inferior cerebellum and the overlying dura, but preserved cerebrospinal fluid flow anteriorly through the neoforamen magnum. 2. No evidence of ventriculomegaly.3. No evidence of cervical syrinx.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.