Reason: Chiari malformation , has NOT had surgery. yearly follow up evaluate for changes History: yearly follow up , headaches. MRI brain:There is 1.1 cm descent of the right cerebellar consult and 0.5 cm descent of the left cerebellar tonsil which is similar to the prior exam. Effacement of the foramen magnum CSF space is similar to the prior exam. Biphasic CSF flow can be seen across the foramen magnum, similar to the prior exam.There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma and pituitary gland appear unremarkable. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable. A small cyst in the pineal gland is unchanged.MRI cervical spine:Redemonstration of tonsillar descent consistent with a Chiari 1 malformation. Minimal prominence of the central canal at C5-C6 is unchanged, however no syrinx is seen in the cervical or upper thoracic cord. Straightening of cervical lordosis, otherwise alignment is anatomic. Normal marrow signal. No spinal or foraminal stenosis.
1.Chiari 1 malformation is stable without new intracranial abnormalities.2.Minimal central canal prominence at C5-C6 without evidence of syrinx.