 BRAIN: There is no evidence of intracranial hemorrhage, mass, or acute infarct. There are no areas of abnormal parenchymal signal. There is no abnormal intracranial enhancement. 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. There is mild mucosal thickening and secretions within the paranasal sinuses. There is fluid within the left mastoid air cells. The skull and scalp soft tissues are unremarkable. SPINE: There are unchanged postoperative findings related to suboccipital craniectomy and C1 laminectomy. There is unchanged crowding at the foramen magnum and a congenitally narrow spinal canal. There is unchanged mild reversal of the normal cervical lordosis and vertebral bodies that are congenitally narrowed in the AP direction. There is lumbar vertebral body scalloping and Gibbus deformity of L2 resulting in a focal lumbar kyphosis. These findings in combination with the congenitally narrow spinal canal result in mild spinal canal stenosis at L1-L2 and L5-S, moderate spinal canal stenosis at L2-L3, and severe spinal canal stenosis at L3-L4 and L4-L5. There is also severe neural foraminal stenosis at all lumbar levels. In addition, at L1-L2 there is disc desiccation and mild loss of disc height. The vertebral bone marrow signal is unremarkable. There is trace prominence of the central spinal canal in the mid thoracic spine. The spinal cord otherwise displays normal signal and morphology with the conus terminating at L1. The paravertebral soft tissues are unremarkable.
1.Stigmata of a achondroplasia including a congenitally narrow spinal canal, and Gibbus deformity of L2 resulting in lumbar kyphosis and multi-level lumbar spinal canal and neural foramen stenosis. 2.Unchanged post-operative findings related to prior sub-occipital craniectomy and C1 laminectomy.3.Unremarkable brain MRI.4.Paranasal sinus inflammatory changes, for which clinical correlation is recommended.