29 years Female (DOB:3/9/1987)Reason: perr patient, diagnosed with small mass to the brain x 10-15yrs/ago History: severe headaches QODPROVIDER/ATTENDING NAME: PATRICIA CHAPMAN-KELLY PATRICIA CHAPMAN-KELLY There is opacification of the sphenoid sinus associated with the T1 and FLAIR signal hyperintensity and deformity of the sphenoid bone and superior aspect of the clivus. This does not appear to involve the cavernous sinuses or pituitary gland. It does appear to narrow the right pterygomaxillary fissure. There is a CT scan from 1/23/2013 which indicates this is also present at this time. In general it has not changed substantially in size since the prior exam. Their imaging studies dating back to 2/24/2004 and 10/8/2002 which demonstrated the same lesion. Signal characteristics and changed somewhat since the 12/11/2008 examThe cerebellar tonsils extend 6 mm below the level of the foramen magnum.The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.There is diffuse marrow replacement present within the visualized calvarium and upper cervical spine
1.There is fibrous dysplasia involving the sphenoid bone appears stable in overall size but has changed in signal characteristics compared to prior exams.2.Marrow replacement is compatible patient's clinical diagnosis of sickle cell.3.Low-lying cerebellar tonsils are present. This compatible with Chiari I malformation. There is no evidence for ventriculomegaly.