Chiari malformation, decompressed, new headaches and neck pain. Brain: There are postoperative findings related to Chiari decompression. There is mild tenting of the posterior portions of the inferior cerebellar hemispheres towards the overlying dura. Otherwise, there is persistent prominence of the retrocerebellar cerebrospinal fluid space. There is intact cerebrospinal fluid flow across the anterior aspect of the foramen magnum, but apparently blunted flow posteriorly. There are multiple cerebral white matter T2 hyperintense lesions, primarily in a periventricular distribution. There is no evidence of intracranial hemorrhage, mass, or acute infarct. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits are grossly unremarkable. There is mucosal thickening in the maxillary sinuses.Cervical Spine: There are numerous patchy areas of T2 hyperintensity in the cervical and imaged portions of the upper thoracic spinal cord. 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 unchanged multilevel degenerative cervical spondylosis, but no significant spinal canal stenosis. The paravertebral soft tissues are unremarkable.
1. Postoperative findings related to Chiari decompression with mild tenting of the posterior portions of the inferior cerebellar hemispheres towards the overlying dura, which is suggestive of adhesion formation. Otherwise, prominence of the retrocerebellar cerebrospinal fluid space persists. 2. Numerous intracranial and upper spinal cord white matter lesions likely represent multiple sclerosis.