 The cerebellar tonsils are unchanged in appearance and terminate 5 mm below the craniocervical junction, but maintain a rounded configuration. There is biphasic CSF flow at the craniocervical junction and normal CSF space at this level. There is no syringohydromyelia. There is straightening of the cervical spine alignment in the sagittal plane and mild apex leftward thoracolumbar curvature that appears centered at L3; these findings were not apparent previously. There is an unchanged 5 mm pineal cyst. 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 no significant spinal canal stenosis. The spinal cord displays normal signal and morphology with the conus medullaris terminating at L1. The paravertebral soft tissues are unremarkable.
1. The cerebellar tonsils extend 5 mm inferior to the foramen magnum, but display rounded morphologies and the CSF flow across the foramen magnum appears to be intact. 2. Straightening of the cervical spine alignment in the sagittal plane and mild apex leftward thoracolumbar curvature that appears centered at L3.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.