 BRAIN: Again seen are findings of Chiari I malformation with pointed configuration of the cerebellar tonsils which descend approximately 6 mm below the foramen magnum similar to prior. There is mild crowding of the posterior frontal magnum. Remainder of the brain is unremarkable with no evidence of intracranial hemorrhage, mass, or acute infarct. There are no areas of abnormal parenchymal signal. The myelination pattern is appropriate for age. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The skull, paranasal sinuses, and scalp soft tissues are unremarkable.CSF flow sequences demonstrate present but mildly diminished biphasic flow involving the posterior aspect of the foramen magnum. There is robust biphasic flow ventrally at the foramen magnum.CERVICAL SPINE: Please note syrinx is almost entirely in the thoracic cord with minimal prominence of the central canal at the cervicothoracic junction measuring up to 1 mm. Visualized upper thoracic cord demonstrates a syrinx measuring up to 1.8 mm at the T4 level on the axial images as well as up to 1.8 mm at the T5 level on the sagittal images. Based on a single scout survey image with T1-weighting (series 1001 image 7) of the mid and lower thoracic cord, appearance of the syrinx is very grossly similar to prior.The vertebral column alignment is within normal limits. The vertebral body and disc space heights are preserved. No spinal canal or neural foraminal stenosis is demonstrated. Paraspinous soft tissues are unremarkable.
1. No significant change in appearance of Chiari 1 malformation with minimally diminished but present biphasic CSF flow dorsally at the foramen magnum. There is robust biphasic flow ventrally at the foramen magnum.2. Please note the syrinx is almost entirely in the mid thoracic cord. The tiny superior component in the lower cervical cord and visualized upper thoracic cord measuring 1 to 2 mm is not significantly changed. Based on a single scout survey image with T1-weighting (series 1001 image 7) including the mid and lower thoracic cord, appearance of the syrinx is very grossly similar to prior. Dedicated thoracic study can be considered as clinically indicated.