 The cerebellar tonsils are low-lying measuring up to 8 mm below the foramen magnum. There is however no significant crowding at the foramen magnum. CSF flow sequence was not obtained. The spinal cord is of normal caliber and signal without evidence of syrinx. The cervical spine is in normal alignment. The vertebral body and disk heights are well-maintained. No worrisome focal marrow signal abnormality is appreciated. There is no significant disk bulge, herniation, spinal canal or foraminal stenosis within the cervical spine. LUMBAR SPINE
1. Cerebellar tonsils measure up to 8 mm below the foramen magnum but with preservation of the subarachnoid spaces at the craniocervical junction. CSF flow sequence was not obtained and if clinically warranted, patient may return for this sequence without charge. 2. No evidence of syrinx in the cervical cord.3. Lumbar spine images demonstrate unchanged appearance of the low-lying spinal cord with suggestion of scarring at its distal aspect at the S2 level.4. Small extradural fluid collection posterior to the expanded dural sac at the S2-S3 levels measures 7 mm in the AP dimension and up to 2.7 cm in the craniocaudal dimensions which is increased since 7/21/2016 although smaller since 10/29/2015, suggesting a small persistent CSF leak. There is also small amount of fluid involving the superficial subcutaneous soft tissues at the S2 level which was also present on prior studies from 10/29/2015 and 7/21/2016, although demonstrates gradual decrease compared to the prior two studies.