Compression of brain [G93.5] / Headache [R51] / Cervicalgia [M54.2], Reason for Study: ^Reason: chiari malformation, new symptoms, please do with CSF flow study History: headaches, neck pain, evaluate for changes and flow No evidence of acute ischemic or hemorrhagic lesion.Chiari I malformation is again seen, unchanged since prior study.The ventricles, sulci and cisterns are symmetric and unremarkable. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, or restricted diffusion/acute ischemia. The midline structures are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.CSF flow studyMaintained bidirectional CSF flow through the anterior aspect of upper cervical spinal cord and brainstem.Maintained bidirectional CSF flow through the posterior aspect of cervical spinal cord as well as anterior aspect of cerebellar tonsil toward 4th ventricle.Cervical Spine MRIStraightening of cervical spine.Spinal cord signal intensity is normal.There are minimal bulging of discs at the level of C3-4 and C 45. However, there is no evidence of spinal canal stenosis or neural foraminal stenosis.
1. No evidence of acute ischemic or hemorrhagic lesion.2. Chiari 1 malformation, unchanged in terms of tonsilar herniation degree.3. No evidence of syrinx on cervical spinal cord.4. Maintained bidirectional CSF flow anterior and posterior aspect of cervical spinal cord. Bidirectional CSF flow was seen anterior aspect of the cerebellar tonsil as described above. 