Reason: history of craniosynostosis, Chiari found on CT , evaluate for changes , yearly follow up History: yearly follow up MRI brain:Postoperative changes from prior cranioplasty in the mid to posterior calvarium with distraction osteotomy. Metal artifact obscures evaluation of the posterior fossa. Calvarium is a similar appearance to the prior exam with mild brachycephaly. There is platybasia with mild scalloping of the clivus, similar to the prior exam. No abnormal signal within the brain parenchyma. Ventricles are unchanged in size and configuration. Flow voids are intact. Again seen are findings of Chiari 1 malformation with descent of the cerebellar tonsils to the C2-C3 level measuring similar at 2.9 cm, previously 2.7 cm. Crowding of the posterior fossa at the level of the foramen magnum is unchanged. CSF flow study demonstrates diminished flow along the anterior foramen magnum with completely attenuated flow posteriorly, similar to the prior exam.MRI cervical spine:Findings of Chiari malformation as above. Alignment is anatomic. No abnormal signal within the cord. Specifically, no syrinx. No abnormal marrow signal. There is crowding at the craniocervical junction as mentioned above, without significant cervical spinal canal or foraminal stenosis inferiorly.
1.Stable findings of Chiari I malformation with cerebellar tonsils extending to the C2-C3 level with severe crowding at the foramen magnum. 2.No evidence of syrinx in the cervical spine.