Evaluate for Chiari and tethered cord status post spinal cord untethering, now with incontinence. Brain: The right cerebellar tonsil extends up to 5 mm inferior to the foramen magnum with associated reduced CSF flow. There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma appears unremarkable. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift. The major cerebral flow voids are intact. The skull, paranasal sinuses, and scalp soft tissues are unremarkable.Spine: There are postoperative findings in the lumbar spine. The spinal cord displays normal signal and morphology. The conus medullaris is situated at the L1 level. The cauda equina nerve roots appear to be intact. There is no evidence of a filar fibrolipoma. There is reduced lumbar lordosis and thoracic kyphosis. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is unremarkable. There is no significant spinal canal stenosis. There is partially-imaged dilatation of the urinary bladder.
1. The right cerebellar tonsil extend up to 5 mm inferior to the foramen magnum with associated reduced CSF flow, but no evidence of syringohydromyelia.2. Postoperative findings related to cord untethering with a conus medullaris is situated at the L1 level and unremarkable cauda equina nerve roots. 