30 years Female (DOB: 4/12/1986)Reason: chiari malformation , pseudotumor cerebri, shunt, new headaches, evaluate for changes, please do with csf flow study. History: new headaches, neck pain, eval for changesPROVIDER NAME: DAVID M. FRIM DAVID M. FRIM MRI brain:The cerebellar tonsils are low-lying extending through the foramen magnum by approximately 5 mm. Is unchanged since the prior exam. CSF flow study displays normal biphasic flow.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.MRI cervical spine:The cervical vertebral bodies are appropriate in overall alignment and height. The cervical spinal cord has normal signal characteristics and overall morphology. No abnormal lesions are identified in the cervical spine.At C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there is no significant compromise to the spinal canal or neural foramina.At C4-5 there is no significant compromise to the spinal canal or neural foramina.At C5-6 there is no significant compromise to the spinal canal or neural foramina.At C6-7 there is no significant compromise to the spinal canal or neural foramina.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact.
There are low lying cerebellar tonsils present. There is no evidence for ventriculomegaly or syrinx. CSF flow pattern on flow study appears nonobstructive.