6-year-old male with history of ATRT. status post radiation and chemotherapy. History of syrinx and spinal cord untethering. Evaluate syrinx There are stable postoperative findings in the posterior fossa related to prior tumor resection. Susceptibility from a right occipital ventriculostomy catheter partially obscures evaluation of the posterior fossa. Deformity of the right cerebellar hemisphere surrounding the resection cavity appears similar to the prior exam. CSF flow analysis shows mild attenuation of biphasic flow at the level of the from foramen magnum anteriorly with no flow identified posteriorly. There is septated syringohydromyelia extending from C4 through L3 which is slightly improved in the cervical spine but unchanged in the thoracic and lumbar spine. For example, at the level of the inferior plate of C5, it measures 5 x 3 mm (1801/18), previously 6 x 5 mm. There are new hypointense foci throughout the cord which demonstrate susceptibility, compatible with air foci from recent surgery.Vertebral body heights and disk spaces are maintained. Alignment is anatomic. There is no significant spinal canal stenosis. There is increased yellow marrow from T12 through S5 which is likely related to prior radiation. There are postsurgical changes of the L5 laminectomy. The conus is low lying, similar to the prior exam. The distal cord and cauda equina are thickened and clumped along the posterior thecal sac, appearing similar to the prior exam. There is no significant anterior motion on prone images.
1.Extensive syringohydromyelia, slightly increased in the cervical spine and unchanged in the thoracic and lumbar spine.2.Postsurgical changes of the L5 laminectomy. Appearance of the distal cord and conus is similar to the prior exam.3.Postsurgical changes in posterior fossa are unchanged.