History of Chiari malformation status post decompression. Interval follow-up exam. Evaluate CSF flow. Brain:Postoperative changes from suboccipital craniectomy. There is an unchanged pointed appearance of the cerebellar tonsils which extend down to the inferior margin of C1. CSF flow imaging through the foramen magnum shows biphasic flow ventrally. This is questionably decreased from prior, however this is suspected to be predominantly due to technical factors in the CSF flow scan as there is a stable appearance of the CSF spaces at the level of the foramen magnum. CSF flow dorsally through the foramen magnum remains decreased.Stable prominence of the supratentorial ventricular system. No abnormal T1, T2, or diffusion weighted signal in the brain. No extra-axial fluid collection. Myelination appears appropriate for age. The expected intracranial vascular flow voids are present. The paranasal sinuses are clear. The visualized mastoid air cells are clear. The orbits are unremarkable.Cervical spine:The vertebral body and intervertebral disc heights are maintained. There is straightening of the cervical lordosis likely related to positioning. Alignment is otherwise maintained. Stable partially visualized epidural lipomatosis in the thoracic spine. The cord signal and morphology is within normal limits.
1. Postoperative changes from suboccipital craniectomy. CSF flow sequences show questionably decreased flow ventrally through the foramen magnum when compared to prior, however this is suspected to be predominantly due to technical factors in the CSF flow scan as there is a stable appearance of the CSF spaces at the foramen magnum. CSF flow dorsally through the foramen magnum remains decreased.2. Stable prominence of the supratentorial ventricular system. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.