New headaches with papilledema, spinal cord syrinx. Follow-up for growth and changes. Brain: The signal intensity and morphology of the cerebrum, cerebellum and brainstem are within normal limits. There is no evidence of Chiari malformation, intra-or extra-axial fluid collection/hemorrhage, mass, mass effect or midline shift. There is no abnormal enhancement in the parenchyma leptomeninges. Normal flow voids are identified in major intracranial vessels.The ventricles, cortical sulci and basal cisterns are normal in size and configuration. Small pituitary gland with partially empty sella appearance is again seen and unchanged since prior study from 5/16/2011. Mild distention of the optic nerve sheaths is also not appreciably changed since 2011. Orbits appear otherwise unremarkable. There is minimal paranasal sinus opacification but improved since remote study from 2011.Spine: There is no significant interval change in the small, long segment cervicothoracic syrinx, for example measuring up to 2 x 3 mm at the C6 level with trace prominence of the central canal more superiorly and inferiorly. Prominent central canal/small syrinx in the thoracic cord measuring up to 1 to 2 mm also not significantly changed and extends to the conus. The conus medullaris tip is located at the mid to lower L2 level. No abnormal thickening or fatty infiltration of the filum terminale is appreciated. Compared to remote lumbar spine MRI dated dated 2007, there is clear decrease in size of the syrinx/central canal at the level of the distal cord.The vertebral column alignment is unchanged. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is unremarkable. There is no significant spinal canal stenosis. The paravertebral soft tissues are unremarkable.
1. Small pituitary gland with partially empty sella appearance and mild distention of the optic sheaths are nonspecific findings and not significantly changed since prior from 5/16/2011. Intracranial hypertension however can be considered in the appropriate clinical setting and can be correlated with opening pressures. Brain MRI is otherwise unremarkable.2. No significant change in prominence of the central canal/small syrinx which extends throughout the cord compared to most recent study.3. Conus terminates at the mid to lower L2 level which is at the lower limits of normal. No appreciable thickening or lipomatous infiltration of the filum terminale.