Suspected Chiari malformation with worsening symptoms: headaches and neck pain. Brain: The cerebellar tonsils are not particularly low-lying and display rounded morphologies. There is intact cerebrospinal fluid flow across the foramen magnum. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is unchanged mild periventricular T2 hyperintensity associated with the right lateral ventricle. The ventricles are unchanged in size and configuration, with effacement of the right frontal horn and relative prominence of the rest of the right lateral ventricle. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.Cervical Spine: The spinal cord displays normal signal and morphology, without evidence of syrinx. There is straightening of the cervical vertebral column alignment in the sagittal plane, but no spondylolisthesis. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is unremarkable. There is no significant spinal canal stenosis. The paravertebral soft tissues are unremarkable.
1. No evidence of Chiari type 1 malformation.2. Unchanged deformed appearance of the right lateral ventricle, which may be related to periventricular leukomalacia.3. No evidence of syringohydromyelia.