 MRI brain: Artifact related to the shunt reservoir limits evaluation particularly in the susceptibility weighted and diffusion weighted images. Some of the images are also motion degraded.There are postsurgical findings related to Chiari decompression. The cerebellar tonsils are unchanged in position and morphology, and extend down to level of the upper margin of the odontoid process. Neo foramen magnum is widely patent.CINE phase contrast CSF flow sequence shows biphasic flow at the level of neo-foramen magnum. CSF flow is well visualized along the ventral aspect with diminished flow dorsally, caudal to the cerebellar tonsils, which is unchanged.There is right frontal ventriculostomy shunt catheter and reservoir with tip terminating in the region of left foramen of Monro, unchanged. The ventricular size and configuration is unchanged. There is no midline shift or mass effect. There are no areas of abnormal signal. There is no diffusion abnormality or susceptibility within limitation of artifact related to the shunt reservoir. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major intracranial vascular structures. MRI spine: There is redemonstration of syringomyelia in the cervical cord which extends from C4-C5 disc space down to mid T1 level, measuring 3 x 5 mm in axial dimensions at mid C7 level, previously 3 x 5 mm, without significant interval change.The cervical spine is in normal alignment, with a normal cervical lordosis. The vertebral body and disk heights are well-maintained. No worrisome focal marrow signal abnormality is appreciated. Stable very minimal degenerative changes are noted in the cervical spine predominantly at C6-C7.There is no significant neural foraminal or spinal stenosis at any levels. Paraspinal soft tissue structures are unremarkable.
1. Stable postoperative findings of posterior fossa decompression for Chiari malformation and right frontal ventriculostomy. Ventricular size and configuration is unchanged.2. No evidence of intracranial hemorrhage or mass.3. Cervical syringomyelia extends from C4-C5 disc space down to mid T1 level, without significant change in size and morphology.4. Mild degenerative changes in the cervical spine without significant neuroforaminal or spinal canal stenosis.