9-year-old nonambulatory boy with history of Chiari malformation and speech apraxia. Brain:There is a right frontal approach ventriculostomy catheter with tip at the foramen of Monro. There is dysplasia of the corpus callosum with dysmorphic lateral and third ventricles, roughly stable in size compared to the CT from 5/2014. The posterior fossa is small and crowded with peglike morphology of the cerebellar tonsils and approximately 23 mm caudal descent. There is tectal beaking. There is no restricted diffusion to suggest acute ischemia. There is no intracranial hemorrhage. A small amount of T2/FLAIR hyperintensity is seen in the subcortical white matter of the cingulate generous, likely gliosis from prior instrumentation. Additionally, there are a few punctate foci of susceptibility artifact, likely related to hemosiderin deposition. Biphasic CSF flow is seen ventrally at the cervical medullary junction. There is no dorsal CSF flow visualized. There is no abnormal parenchymal or leptomeningeal enhancement. The major flow-voids are preserved. The orbits, paranasal sinuses, and calvarium are unremarkable.CERVICAL SPINE
1.Intracranial findings compatible with Chiari II malformation. No significant interval change. No acute abdominal disease.2.Dysplastic corpus callosum with dysmorphic lateral and third ventricles. Ventriculostomy in place with stable ventricular size.3.Syrinx extending through much of the spinal cord with atrophy of the thoracic and lumbar cord.4.Multiple findings in the lumbosacral junction compatible with spinal dysraphism and likely prior surgery perhaps for myelomeningocele repair.5.The spinal cord is low-lying and does not appear to change position on prone imaging, findings which may indicate tethered cord.