 BRAIN: A right parietal approach ventriculostomy catheter is again demonstrated with its tip in the medial aspect of the right lateral ventricle. There is no evidence of hydrocephalus with decreased size of the ventricular and adjacent CSF spaces. Findings are consistent with a small posterior fossa and at least Chiari I malformation. Partial agenesis of the corpus callosum is again noted with deficient rostrum, posterior body and splenium. A right paramedian ventricular cyst extending to the vertex via a small communication in the midline is again noted. Bilateral hemispheres are asymmetric, right greater than left which can be seen in the setting of hemimegalencephaly, and bilateral cortical dysplasias.There has been interval posterior fossa decompression, including suboccipital craniectomy and partial resection of the posterior arch of C1. Postsurgical changes related to craniosynostosis are also again noted. Biphasic CSF flow is present posteriorly at the foramen magnum and level of the cerebellar tonsillar tips.CERVICAL SPINE:Suboccipital craniectomy and partial resection of the posterior arch of C1 is noted. The cervical vertebral bodies are appropriate in height. Sagittal alignments are maintained. Bone marrow signal is within normal limits. Mild levoconvex curvature of the cervical spine of is noted.The cervical spinal cord has normal signal characteristics and overall morphology.There is no significant degenerative change, spinal canal stenosis, or neural foraminal narrowing in the cervical spine.The vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits.
1.Right parietal approach ventriculostomy catheter terminating in the right lateral ventricle. No current evidence of hydrocephalus with decreased size of the ventricular and adjacent CSF spaces.2.Complex congenital malformations in the supratentorial and infratentorial brain.3.Postsurgical changes related to posterior fossa decompression. Biphasic CSF flow is present posteriorly at the foramen magnum and level of the cerebellar tonsillar tips.4.Redemonstrated postsurgical changes of the calvarium related to prior craniosynostosis repair. 5.No syrinx or other significant abnormality in the cervical spine.