 BRAIN: There is no evidence of intracranial hemorrhage, mass, or acute infarct. There are no areas of abnormal parenchymal signal. The myelination is within normal limits for age. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. There is a 6 mm presumed pineal cyst. There is fluid within the bilateral mastoid air cells and middle ear cavities. The skull and scalp soft tissues are unremarkable. SPINE: There is transitional anatomy with either 13 thoracic type vertebrae or 6 lumbar type vertebrae (the latter counting scheme will be used for the purposes of this exam). The cerebellar tonsils have a normal configuration without herniation. There is normal biphasic CSF flow anteriorly and slightly decreased flow posteriorly at the craniocervical junction. 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 stenosis. The spinal cord displays normal signal and morphology with the conus terminating at the L2-L3 level. The filum is upper normal at the L3 level measuring up to 2 mm without abnormal T1 hyperintensity or thickening below this level. However, the filum tapers by the L5-L6 level. There is normal anterior translation of the conus upon prone positioning. There is no evidence of a sinus tract at the location of the skin marker. The paravertebral soft tissues are unremarkable.
1.No evidence of Chiari malformation. 2.Transitional anatomy with either 13 thoracic type vertebrae or 6 lumbar type vertebrae (the latter counting scheme is used for the purposes of this exam). If surgery is to be contemplated, please correlate with imaging of the entire spine.3.Low normal positioning of the conus (although the significance of this is indeterminate in transitional anatomy) without evidence of fibrofatty infiltration or restricted motion upon prone positioning. No definite MR evidence of tethered cord.4.No evidence of a sinus tract deep to marked sacral dimple.