Female, 13 years old, with syrinx of the cervical and thoracic spinal cord, yearly follow-up. Redemonstrated is evidence of prior suboccipital craniectomy and resection of the posterior arch of C1. The foramen magnum remains somewhat crowded with a relatively pointed configuration of the cerebellar tonsils, but this is similar to the prior examination.Since the prior examination, the patient's cervicothoracic syrinx has significantly increased in caliber, now measuring 14 x 10 mm at the C6-7 level, previously 7 x 4 mm at this level. The syrinx cavity and associated T2 signal abnormality have also expanded in the craniocaudal dimension extending from the C1 level down to the T11 level. The syrinx itself contains multiple septations.Slight reversal of the cervical lordosis is seen. Spinal alignment is otherwise unremarkable. Vertebral body heights are preserved. No areas of marrow replacement or edema are seen. The thyroid gland is diffusely bulky and heterogeneous with a superimposed 15 mm T2 hyperintense lesion in the left thyroid lobe.
1.Demonstration of findings related to prior Chiari decompression. The foramen magnum remains somewhat crowded but similar to the prior study.2.Interval worsening of the cervicothoracic syrinx is demonstrated.3.The thyroid gland is incidentally noted to be prominent and diffusely heterogeneous with a focal lesion in the left lobe. This can be further assessed with sonography if clinically warranted.