55-year-old female with history of Chiari mouth and patient status post decompression Study limited by patient motion. CERVICAL SPINE:Vertebral body heights and disk spaces are maintained. No abnormal marrow signal.There are postsurgical changes of Chiari decompression with suboccipital craniotomy and resection of the posterior arch of C1 appearing similar to the prior exam. No evidence of tonsillar herniation. There is edema and areas of encephalomalacia within the inferior cerebellum which overall appear similar to the prior exam. A catheter extending from the superior fourth ventricle passing through the dorsal myelotomy defect and terminating with its tip in the dorsal aspect of the upper cervical spine is unchanged in position. Mild dilatation of the fourth ventricle is unchanged.A large septated syrinx extending from C1 to C6 has increased in size proximally but is similar in extent. For example, at the level of C1, the syrinx cavity measures 16 x 14 mm (9/10), previously 12 x 11 mm. At the level of C5, the central canal measures approximately 10 x 7 mm (9/27), previously 11 x 8 mm.Evaluation is limited due to motion, however multilevel cervical spondylotic changes appear similar to the prior exam without significant spinal canal stenosis.THORACIC SPINE:Superior endplate deformities of T7, T8 and T10 appear similar to the prior exam with minimal endplate degenerative changes. Disk spaces are maintained. Small hemangioma within the T7 vertebral body. No significant spinal or neural foraminal stenosis.There is a prominent central canal with a syrinx at the level of C6-C7 which is slightly increased since the prior exam, measuring 5 x 4 mm (18/24). Morphology of the cord throughout the lumbar spine appears distorted, possibly due to traction or atrophy, similar to the prior exam.
Postsurgical changes of Chiari decompression with increasing syrinx at the cervicomedullary junction. A small syrinx within the mid thoracic cord is also slightly increased.