Female, 33 years old, with severe headache, status post Chiari decompression. Brain:Image quality is compromised due to motion artifact. Multiple repeat sequences were attempted.Findings are seen compatible with Chiari decompression including suboccipital craniectomy, resection of the posterior arch of C1, and probable cauterization of the cerebellar tonsils. Allowing for motion artifact, the appearance of the cerebellum is not significantly changed. Phase contrast flow imaging is technically inadequate for the assessment of CSF flow through the foramen magnum.The remainder of the brain parenchyma is within normal limits. No areas of pathologic signal abnormality are seen. No edema or mass effect is detected. There are no findings to suggest acute intracranial hemorrhage or any abnormal extra-axial fluid collection. The ventricular system is normal in size and morphology.C-spine:Findings related to posterior instrumented fusion and multilevel laminectomy are again seen appearing similar to prior. The spinal canal and thecal sac are expanded between C3 and C6.Again, allowing for motion artifact, the spinal cord demonstrates normal signal intensity and morphology. No epidural abnormalities are suspected.Spinal alignment is anatomic. Vertebral body height and morphology are within normal limits. No pathologic marrow replacement or marrow edema is observed. No spinal canal stenosis is observed. Most of the neural foramina are not well assessed due to metallic artifact.
1.Image quality is significantly compromised due to motion artifact. In particular, the phase imaging CSF flow sequence is technically inadequate.2.Findings related to Chiari decompression are seen showing no significant change from the prior examination.3.Evaluation of the brain is otherwise unremarkable with no evidence of any acute intracranial abnormality.4.Imaging of the cervical spine redemonstrates findings related to posterior decompression and instrumented posterior fusion. The spinal canal remains well decompressed from C3 through C6. No spinal cord abnormalities are observed within the limitations of significant artifact.