16 years, Female, year post Chiari decompression, new headaches. Brain: Interval postsurgical changes of posterior fossa surgical decompression are seen including suboccipital craniectomy and resection of the posterior arch of C1. Posterior fossa structures at the foramen magnum are well decompressed with increase in size of the CSF spaces. There is preserved biphasic ventral and dorsal CSF flow, which is likely improved compared to prior although outside comparison CSF study is technically limited. Remainder of the brain appears unremarkable. No intracranial mass or mass-effect. Pituitary gland is within normal limits for age. The ventricles are within normal limits in size and configuration. No restricted diffusion to suggest acute ischemia. No intracranial hemorrhage. Major flow-voids are preserved. Paranasal sinuses and mastoid cells are clear. Bone marrow signal and extracranial soft tissues are within normal limits aside from the above-mentioned postsurgical changes. Cervical spine: The cervical spine is in normal alignment. The vertebral body and disk heights are well-maintained. No worrisome focal marrow signal abnormality is appreciated. No cord signal abnormality is definitively appreciated within the limits of motion degradation. No evidence of syrinx.There is no significant disk bulge, herniation, spinal canal or foraminal stenosis at any level within the cervical spine.
1. Interval postsurgical changes of posterior fossa decompression. The CSF spaces at the foramen magnum are well decompressed, and CSF flow is preserved.2. Brain and cervical spine MRI are otherwise unremarkable.