Female, 38 years old, with headache, status post Chiari decompression, six-week follow-up exam with CSF study. Postoperative findings are seen compatible with interval Chiari decompression including suboccipital craniectomy and resection of the posterior arch of C1. Edema and a small amount of fluid in the suboccipital extracranial soft tissues are within acceptable limits.With the postoperative changes, the caliber of the CSF space at the level of the posterior foramen magnum has been expanded. The cerebellar tonsils demonstrate a relatively round morphology. CSF flow imaging shows little if any biphasic biphasic signal alteration which may be technical in nature.Spinal alignment is anatomic. Vertebral body morphology and signal characteristics are within normal limits. The visualized spinal cord demonstrates normal signal intensity and morphology. No significant degenerative disc disease is seen. No spinal canal or neuroforaminal stenosis is detected.Incidental note is made of a partially cystic pineal gland which is, however, under 1 cm in diameter.
Expected findings status post Chiari decompressive surgery. The caliber of the CSF space along the posterior foramen magnum is expanded relative to the preoperative study. CSF flow imaging is felt to be technically unreliable.