 Brain: Again seen are postoperative findings related to Chiari decompression. Minimal T2 hyperintensity and volume loss in the inferior right cerebellar hemisphere compatible with gliosis. Neo-foramen magnum is widely patent. CSF flow is preserved across the anterior and posterior aspects of the neo-foramen magnum, although the anterior flow column remains minimally focally constricted due to the retroflexed dens. The third and lateral ventricles are mildly prominent but unchanged. Cerebral aqueduct is patent, most evident on 3-D T2 as well as CSF flow sequences. There is no midline shift or mass effect. There is no evidence of acute infarct or hemorrhage. Spine: There is trace prominence of the central canal from C3 to C5 levels as before. Again seen is a syrinx extending from the lower C6 level into the thoracic cord. Syrinx measures approximately 2 x 2 mm at the T1 level, previously 3 x 3 mm on cervical spine study from 7/27/2016. At the T3-T4 level, the syrinx measures 2 x 3 mm, previously 3 x 4 mm on thoracic study from 2/11/2016.Caudally in the thoracic spine, the syrinx tapers inferiorly to the T11-12 level which is unchanged. The vertebral column alignment is within normal limits. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is unremarkable. There is no significant spinal canal or neural foraminal stenosis at any level. Conus terminates normally at the upper L2 level.
1.Postoperative findings related to Chiari I decompression with preserved ventral and dorsal CSF flow at the foramen magnum.2.Mild decrease in size of cervicothoracic syrinx compared to 7/27/2016 and 2/11/2016.3.Unchanged mildly dilated lateral and third ventricles with patent cerebral aqueduct.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.