25 years Female (DOB: 1/9/1991)Reason: Chiari malformation , new symptoms, lumbar peritoneal shunt, pseudotumor cerebri, new headaches, evaluate for changes. Please do with csf flow History: new headachePROVIDER NAME: DAVID M. FRIM DAVID M. FRIM MRI brain:The CSF spaces are appropriate for the patient's stated age with no midline shift. The patient status post posterior fossa decompression. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.An old ventriculostomy tract is identified coursing the right frontal lobe to the right lateral ventricle.On susceptibility imaging there are punctate foci of signal loss present in the cerebellar hemispheres as well as the brainstem.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.MRI cervical spine:The cervical vertebral bodies are appropriate in overall alignment and height. The cervical spinal cord has normal signal characteristics and overall morphology. No abnormal lesions are identified in the cervical spine. There is mild reversal of the normal cervical curvature present which could be positional or related to muscle spasm. No obstruction at the level of the foramen magnum is appreciated.At C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there is no significant compromise to the spinal canal or neural foramina.At C4-5 there is no significant compromise to the spinal canal or neural foramina.At C5-6 there is no significant compromise to the spinal canal or neural foramina.At C6-7 there is no significant compromise to the spinal canal or neural foramina.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact.
Status post Chiari decompression without evidence for syrinx or ventriculomegaly