Chiari malformation decompression with new symptoms of balance and headache changes Brain: There are postsurgical changes of suboccipital craniectomy and resection of the posterior arch of C1 for Chiari decompression. There has been partial cauterization of the cerebellar tonsillar tissue. There is biphasic CSF flow ventrally at the foramen magnum. CSF flow dorsally is not well assessed due to technique, however, is grossly preserved. CSF space dorsally at the neoforamen magnum remains widely patent with no evidence of crowding.There is no evidence of acute infarct, hemorrhage, or other parenchymal signal abnormality. No intracranial mass or mass effect, midline shift, or herniation. Ventricles remain normal in size. Bone marrow signal and remainder of the extracranial soft tissues are grossly unremarkable.Cervical spine: Cervical spine images are moderately motion degraded, and patient had difficulty tolerating the full study. The cervical spine is in normal alignment, with a normal cervical lordosis. The vertebral body and disk heights are well-maintained. No worrisome focal marrow signal abnormality is appreciated. The spinal cord is of normal caliber and signal. There is no significant disk bulge, herniation, spinal canal or foraminal stenosis within the cervical spine.
1. Postsurgical changes of Chiari I surgery with posterior fossa structures at the foramen magnum appearing well-decompressed.2. Motion degraded cervical spine study without evidence of syrinx or other significant abnormality.