Male, 19 years old, with history of Chiari status post decompression. Assess decompression and for syrinx. Evidence of Chiari decompressive surgery is again seen with suboccipital craniectomy and resection of the posterior arch of C1. A catheter remains visible spanning from the fourth ventricle through the foramen of Magendie.Morphology and positioning of the cervical tonsils is similar to the prior exam. As on the prior examination, CSF flow is seen anteriorly along the brainstem through the foramen magnum with attenuation at the level of the dens. Little if any flow is seen posteriorly through the foramen magnum or around the cerebellar tonsils.A syrinx cavity is redemonstrated beginning at the C6-7 disc level and continuing to the mid T1 level, unchanged from prior. The maximum caliber of the syrinx measures approximately 3 x 2 mm which is not significantly changed from the prior exam.Evaluation of the thoracic cord is limited by motion artifact. This makes accurate assessment of the thoracic syrinx unreliable. However, it does appear that the discontiguous syrinx extending from the upper thoracic region to T7 may be somewhat improved.Multiple Schmorl's nodes with mild anterior wedging from C6 through T10 are again seen, similar to the prior examination and suggestive of Scheuermann's disease.Spinal alignment is anatomic. Vertebral body morphology and signal characteristics are within normal limits. No significant spinal canal or neuroforaminal stenosis is identified.
1.Redemonstration of findings compatible with Chiari malformation and decompressive surgery without significant interval change.2.Stable syrinx in the lower cervical region.3.Poor visualization of the thoracic syrinx due to motion artifact. However, it does appear that at least some portions of the syrinx may be improved from prior.