Chiari malformation decompression/VP shunt: headaches, neck pain, and back pain. Brain: There are postoperative findings related to Chiari decompression. There is deformity of the inferior cerebellum, which appears to contact the overlying dura. There appears to be deficiency of flow across the neo-foramen magnum, although this may be in part be artifactual. There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma appears unremarkable, aside from minimal scattered foci of nonspecific T2 hyperintensity. There is a right transfrontal ventricular catheter that terminates in the region of the left foramen of Monro. The ventricular system is not dilated. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits are grossly unremarkable.Spine: There are postoperative findings in the posterior lower cervical spine. There is straightening of the cervical spine alignment in the sagittal plane. The rest of the vertebral column alignment is within normal limits. There is mild degenerative spondylosis at multiple levels of the cervical spine, lower thoracic spine, and at L5-S1, with up to slight spinal canal stenosis. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is unremarkable, aside from degenerative endplate signal alterations in the lower thoracic spine. The spinal cord displays normal signal and morphology and the conus medullaris is appropriately situated at the L1 level. The paravertebral soft tissues are unremarkable.
1. Postoperative findings related to Chiari decompression with evidence of adhesions involving the inferior cerebellum with what appears to be associated diminished cerebrospinal fluid flow in this region.2. No evidence of syringohydromyelia or hydrocephalus.