Female, 26 years old, status post Chiari decompression with new symptoms in the right hand. Findings are seen compatible with Chiari decompression including suboccipital craniectomy and resection of the posterior elements of C1-C4. The CSF space below the cerebellum is widely expanded similar to prior. Adequate biphasic CSF flow is seen along the ventral surface of the brainstem through the foramen magnum. However, only minimal CSF flow is detected along the dorsal brainstem and virtually none is seen within the expanded CSF space. Swirling flow related artifact is, however, present in this space on conventional images.An extensive severe spinal cord syrinx is redemonstrated becoming most prominent at the C3 level and continuing through the entire cervical spine into the thoracic region. The syrinx measures up to 5 mm in the AP dimension and up to 12 mm in the transverse dimension. The caliber of the syrinx does not appear to have changed significantly. Only a thin rim of residual spinal cord parenchyma is seen surrounding the syrinx.Spinal alignment is anatomic. Vertebral body heights are preserved. No evidence of marrow replacement or marrow edema is detected. Mild disc degeneration is seen at C5-6 and C6-7. No significant spinal canal or foraminal compromise is detected.
Findings are redemonstrated compatible with Chiari decompression. The CSF space below the cerebellum is widely decompressed, similar to the prior examination.Adequate CSF flow is seen along the ventral brainstem. Dorsally, only mild flow is seen along the brainstem and little if any detectable flow is present within the enlarged posterior CSF space. These findings could reflect turbulent or slow flow which is unable to be resolved by phase contrast technique, or perhaps restricted communication between the dorsal and ventral CSF spaces which could be related to adhesions. In any event, the findings are unchanged.Stable severe and longitudinally extensive spinal cord syrinx. No new findings are observed which account for the patient's symptoms.