 Brain: There are unchanged postoperative findings in the posterior fossa related to prior tumor resection without evidence of nodular enhancement in the region of the resection cavity or elsewhere in the intracranial compartment. There is susceptibility artifact related to a right transoccipital catheter device. There is unchanged deformity of the right cerebellar hemisphere surrounding the resection cavity with tenting towards the overlying dura inferiorly, which appears unchanged. The brain parenchyma appears unchanged. The ventricles are unchanged in size and configuration.Spine: There is high T1 signal within the vertebral bone marrow within the T12 through S5 vertebral bodies related to radiotherapy. There are also postoperative findings in the lower lumbar spine related to tethered cord release with patchy enhancement in the posterior soft tissues. There is increase in the caliber and extent of the septated syringohydromyelia, now measuring up to 10 mm in width and extending from the level of C2-C3 level to the conus which is located approximately at the inferior L5 endplate. There is persistent patchy T2 hyperintensity superior to the syringohydromyelia, which may represent edema. The vertebral column alignment is within normal limits. The vertebral body and disc space heights are intact. There is no significant spinal canal stenosis. The partially imaged urinary bladder appears to be enlarged.
1. Unchanged post-therapy findings in the posterior fossa with deformity of the right cerebellar hemisphere with a configuration that is suggestive of adhesion formation, but no definite evidence of tumor recurrence.2. Postoperative findings related to tethered cord release with persistent low lying conus medullaris and interval increase in size of the extensive syringohydromyelia.Discussed with Dr. Kramer at 10:20 AM on 5/18/15.