 Brain MRISignificant metallic artifacts on left suboccipital craniectomy site and right PICA origin area due to prior clipping, this degraded image quality.No evidence of acute ischemic or hemorrhagic lesion on this scan.There is focal encephalomalacia on the right frontal lobe which represent prior ventriculostomy tube track. Left posterior parieto-temporal approach ventriculostomy tube is demonstrated with metallic artifacts on the left scalp which represents burr hole and reservoir.The ventricles, sulci and cisterns are symmetric and unremarkable. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia, or abnormal contrast enhancement. The midline structures are normal. Craniocervical junction cannot be precisely evaluated due to artifacts. However, the position of bilateral cerebellar tonsil appears to be unchanged. The paranasal sinuses and mastoid air cells are clear.Brain MRA3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate normal ICAs, MCAs and ACAs. Vertebrobasilar system appears to be normal. Bilateral distal vertebral arteries cannot be evaluated precisely due to artifacts. No intracranial arterial aneurysm was seen. No significant (more than 50%) luminal stenosis of intracranial arterial system.C-Spine and T-SpineRedemonstration of syringomyelia from skull base to the level of T11-12 which does not show any significant interval change. The measured largest diameter of syrinx cavity appears to be stable.No change of mid to lower thoracic spine scoliosis.There is no evidence of spinal canal stenosis.No evidence of neuroforaminal stenosis.
1. Post-decompression status of Chiari malformation. 2. No evidence of acute ischemic or hemorrhagic lesion.3. Stable left parieto-temporal ventriculostomy tube, ventricular system size, bilateral cerebellar tonsil position, the extent of syrinx from skull base to T11-12 level and its size since prior scan.4. No change of midthoracic scoliosis.