 Brain MRI: There is susceptibility artifact related to braces which limits evaluation of the frontal lobes on multiple sequences. Again seen are postsurgical changes of Chiari I decompression with preserved CSF spaces ventrally and dorsally at the neoforamen magnum, much improved since preoperative study from 5/1/2014. Cerebellar tonsils extend to the level of the upper aspect of the odontoid process. The dorsal aspect of the cerebellum more superiorly abuts the craniectomy margin as seen before. There is biphasic CSF flow ventrally and dorsally at the foramen magnum, mildly diminished posteriorly, but much improved since preoperative study from 5/1/2014.Remainder of the brain is essentially unremarkable. Prominent dural calcifications are incidentally noted. Partially empty sella is seen which can be normal variant and unchanged. Ventricles and sulci are within normal limits and unchanged. The basal cisterns remain patent. There is no midline shift or mass effect. Minimal nonspecific punctate foci of T2/FLAIR hyperintensity are seen in the frontal white matter. No diffusion abnormality. No extra-axial fluid collection. Normal flow-voids are demonstrated in the major intracranial vascular structures. Cervical MRI: There is no abnormal cord signal or evidence of syrinx. Vertebral body heights and alignment are maintained. Minimal degenerative changes are seen. There is no spinal canal or neural foraminal stenosis at any level. Bone marrow signal is benign. Paraspinous soft tissues tissues are unremarkable.Thoracic MRI: No abnormal cord signal or evidence of syrinx. Vertebral body heights and alignment in the thoracic spine are maintained. Minimal degenerative changes are seen including small left paracentral disc protrusion at the T2-T3 level as seen before, trace disc bulges more inferiorly, as well as mild degenerative changes involving the costovertebral, costotransverse, and facet joints. There is no significant spinal canal stenosis or neural foraminal stenosis at any level. Bone marrow signal is benign. Paraspinous soft tissues are unremarkable.
1. Postoperative changes related to Chiari decompression are again seen. There is biphasic CSF flow ventrally and dorsally at the foramen magnum, mildly diminished posteriorly, but much improved since preoperative study from 5/1/2014.2. No cord signal abnormality or evidence of syrinx in the spinal cord.