Axenfeld-Rieger syndrome and fibro-osseous clival lesion status post multiple surgeries. Evaluate for Chiari malformation and CSF flow, pseudotumor cerebri, status post lumboperitoneal shunt and with continued headache. The cerebellar tonsils are minimally low-lying, perhaps to a slightly lesser degree that previously. The cerebellar tonsils also display a rounded morphology and there is essentially intact CSF flow across the foramen magnum. There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma and pituitary gland appear unremarkable. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues appear unchanged with postoperative alterations in the central skull base.
1. The cerebellar tonsils are minimally low-lying, perhaps to a slightly lesser degree that previously. In addition, the cerebellar tonsils display a rounded morphology and there is essentially intact CSF flow across the foramen magnum. 2. Stable postoperative alterations in the central skull base related to fibro-osseous lesion resection.