 Again seen is evidence of prior Chiari decompression with suboccipital craniectomy and dorsal C1 laminectomy. Cerebellar tonsils again seen extending to the upper margin of the C1 level. There is residual minimally diminished CSF space at the foramen magnum similar to prior but much improved since preoperative study from 2013. Ventricular caliber remains unchanged without evidence of hydrocephalus. No extra-axial collections. No evidence of acute ischemia or hemorrhage. No intracranial mass effect, midline shift, or herniation. CSF flow sequence is nondiagnostic.SPINE
1. Again seen are postsurgical changes of Chiari I decompression and significant improvement in CSF spaces at the craniocervical junction compared to the preoperative study. Compared to postoperative cervical spine MRI, 10/17/2014, residual minimally diminished CSF space at the foramen magnum is not significantly changed. Subtle T2 hyperintensity involving the cervical cord at the C2 level is less prominent. No new cord signal abnormality or evidence of a discrete syrinx in the spinal cord.2. Mild degenerative changes in the cervical, thoracic, and lumbar spine. No high-grade spinal canal or high-grade neural foraminal stenosis at any level. Please see details above.