 Brain: Postsurgical changes are present related to decompression including suboccipital craniectomy and C1 laminectomy. The CSF spaces at the foramen magnum ventrally and dorsally have significantly increased in size, and the cerebellar tonsils are no longer flattened. There is persistent mild cerebellar tonsillar ectopia with the left cerebellar tonsil extending to the C1 level. There is no evidence of intracranial hemorrhage or acute infarct. A small pineal cyst is unchanged in size. There are no areas of abnormal parenchymal signal. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The skull, paranasal sinuses, and scalp soft tissues are unremarkable. 3-D T2 Fiesta and CSF flow images are severely degraded due to technical limitations. Cervical Spine: Postsurgical changes are present including C1 laminectomy. There is mild straightening of the normal cervical lordosis which may be due to positioning. The vertebral body heights and disc space heights are preserved. The vertebral bone marrow signal is unremarkable. The spinal cord displays normal signal and morphology. There is no evidence of syrinx of the cervical or upper most visualized thoracic cord. The paravertebral soft tissues are unremarkable.Mild disc protrusions are present at C3-C4, C4-C5, and C5-C6 without significant central canal stenosis or foraminal stenosis.
Interval postsurgical changes related to Chiari decompression with significant enlargement of CSF spaces ventrally and dorsally at the foramen magnum.