Benign intracranial hypertension [G93.2], Reason for Study: ^Reason: CSF flow, h/o of Chiari History: HA, n/v Brain MRIThere is no evidence of acute ischemic or hemorrhagic lesion on the scan.Post suboccipital cranium activity with dominant displacement of cerebellar tonsils appear to be unchanged since prior scan.Pontine FLAIR/T2 high signal intensity lesions are again seen, unchanged since May 11 2016.The ventricles, sulci and cisterns are unremarkable. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, or restricted diffusion/acute ischemia.Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.CSF flow study shows cranial and caudal CSF flow through anterior and posterior aspect of foramen magnum as well as herniated cerebellar tonsil.Cervical spine MRIRedemonstration of suboccipital craniectomy with cerebellar tonsillar herniation, unchanged since prior scan. There is normal cervical lordosis. The cranial-cervical junction is normal. The spine alignment is anatomic. The vertebral body height is preserved. The bone marrow and end plates demonstrate a normal MR appearance. The cord signal is normal. The epidural space, thecal sac, and spinal cord are preserved with no evidence of spinal canal/neural foraminal stenosis, cord compression or myelopathy.
1. Post suboccipital craniectomy status with bilateral cerebellar tonsilar herniation, unchanged since prior scan.2. No evidence of acute ischemic or hemorrhagic lesion. Unchanged non specific pontine FLAIR/T2 high signal intensity lesions.3. Demonstration of cranial and caudal CSF flows through the anterior and posterior aspects of foramen magnum level.4. No evidence of syrinx of cervical spinal cord. 