25-year-old male with Chiari I malformation status post Chiari decompression with hydrosalpinx and pseudotumor treated with lumbar peritoneal shunt. MRI brain:No restricted diffusion to suggest acute ischemia or susceptibility lesions to suggest hematoma. Again seen are posterior fossa postsurgical changes. A stent is seen extending from the cerebral aqueduct inferiorly to posterior spinal canal at the level of C2. Both are unchanged in position. Crowding of the foramen magnum by low lying cerebellar tonsils is redemonstrated, however with slightly less beaking of the cerebellar tonsils. No other structural abnormalities. No brain parenchymal signal abnormalities are identified. The ventricles are decompressed. No mass-effect or midline shift.CSF flow studies demonstrates preserved flow, anterior greater than posterior, through neo-foramen magnum. Spine MRI:Alignment, vertebral body heights, and bone marrow signal appear normal. The previously described syrinx appears shorter now extending from C3 to approximately C7 (decompressed from C7 to T5), it also appears smaller in diameter to prior exam. For example, at the level of C5 measures 4 mm versus previously 8 mm. No new syrinx is identified. Conus ends at L1, which is normal. Mild degenerative disease is again seen in several cervical and thoracic intravertebral disks, appearing similar prior study. Mild disk protrusions are seen at T3-T4, minimally at T4-T5, T9-T10, and T11-12. No central canal stenosis or neural foraminal narrowing.
1.Decreased size of previously described hydrosalpinx.2.Interval decrease in the beaking of the bilateral cerebellar tonsils. Preserved CSF flow through the neo-foramen magnum.3.No hydrocephalus. 