41-year-old female with Chiari malformation, decompressed, experiencing headache for one month with neck pain. Brain: Redemonstrated are stable postoperative findings related to Chiari decompression. There is persistent prominence of the retrocerebellar cerebrospinal fluid space. Redemonstrated is biphasic cerebrospinal fluid flow at the level of the cerebellar tonsils, unchanged in extent. As before, there are multiple cerebral white matter T2 hyperintense lesions, primarily in a periventricular distribution, without new lesions identified. There is no evidence of intracranial hemorrhage, mass, or acute infarct. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits are grossly unremarkable. Paranasal sinus mucosal thickening has improved.Cervical Spine: Redemonstrated are numerous patchy as well as more focal areas of T2 hyperintensity in the cervical and imaged portions of the upper thoracic spinal cord, stable in appearance, without new lesions identified. 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 unchanged multilevel degenerative cervical spondylosis, but no significant spinal canal stenosis, stable in appearance. The paravertebral soft tissues are unremarkable.
1. Stable postoperative findings related to Chiari decompression.2. Numerous stable intracranial and upper spinal cord white matter lesions likely represent multiple sclerosis.