Chiari, syrinx, and fatty filum: 6 month follow up with worsening back pain. Cervical Spine: The cerebellar tonsils have a pointed morphology and extend up to approximately 15 mm inferior to the foramen magnum. There is an intact, albeit slightly narrowed column of biphasic cerebrospinal fluid flow across the anterior aspect of the foramen magnum, while there is blunted cerebrospinal fluid flow across the posterior aspect of the foramen magnum. There is interval increase in size of the caliber of the septated syrinx at the C5 through C7 level, measuring up to 8 mm in the anteroposterior dimension, previously 4 mm. Lumbar Spine: There is no evidence of fibrofatty filum terminale or other mass lesions in the spine. There is partially-imaged syringohydromyelia in portions of the thoracic spinal cord. The conus medullaris is situated at the L1 level. The vertebral column alignment is within normal limits. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is unremarkable. There is no significant spinal canal stenosis. The paravertebral soft tissues are unremarkable.
1. Findings compatible with Chiari type 1 malformation with pointed cerebellar tonsils that extend up to approximately 15 mm inferior to the foramen magnum. 2. Interval increase in size of the cervical syrinx. The thoracic syringohydromyelia is otherwise only partially-imaged.3. No evidence of fibrofatty filum terminale.