46-year-old female with increased ICP and history of SAH status post right craniotomy with PCOM aneurysm clipping. Increased ICP? Postoperative changes status post right frontal craniotomy for clipping of an aneurysm is again noted without interval changes. Right-sided ventricular catheter with no interval change in its course and position with its tip located in the frontal horn of the right lateral ventricle. Small amount of hemorrhage is again noted in the dependent portion of the occipital horn of the right lateral ventricle, unchanged.Ventricular system and basal cisterns appear unchanged. No evidence of acute hemorrhage, edema or mass effect.Multiple prior studies were reviewed and demonstrate persistent low positioned cerebellar tonsils with crowding of the foramen magnum, raising a question of Chiari malformation. If clinically indicated, MRI with flow study may be considered.
1. Stable postoperative changes.2. Persistently low positioned cerebellar tonsils with crowding of the foramen magnum are noted raising a question of Chiari malformation. If clinically indicated, MRI with flow study may be considered.