File:Chiari 1 - pre and post decompression surgery (Radiopaedia 42945-46188 Sagittal 31).png

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Chiari_1_-_pre_and_post_decompression_surgery_(Radiopaedia_42945-46188_Sagittal_31).png ‎(515 × 512 pixels, file size: 197 KB, MIME type: image/png)

Summary:

Description
  • Radiopaedia case ID: 42945
  • Image ID: 19569682
  • Image stack position: 31/71
  • Plane projection: Sagittal
  • Study findings: Interval decompressive occipital craniectomy noted with dural thickening deep to the operative site. No intracranial hemorrhage or collection seen on the available images. No mass, midline shift or edema. No area of abnormal contrast enhancement. Size of ventricles and sulci is normal for the patient's age and there is normal grey-white differentiation with no CT evidence of focal or diffuse white matter change at this stage. Low position of cerebellar tonsils noted. Bones, air sinuses and orbits appear normal. No fracture of cranial base or vault. No scalp hematoma. CONCLUSION: Post-operative occipital change with decompressive occipital bone resection. There is some dural thickening. No surgically drainable component identified. Remainder of the brain appears normal. CT CERVICAL SPINE In the position of imaging, the cervical lordosis is reversed. The neck is held flexed slightly, convex rightward. No loss of vertebral body height or intervertebral disc height. Posterior elements of C1 incomplete, ? resected or absent. There is some minor osteophytosis around the anterior arch of C1. No cervical fracture or dislocation. Subtle bony lucency through right side of T1 transverse process suggests a small undisplaced fracture here. No evidence of a traumatic disc prolapse. No prevertebral soft tissue swelling. Visible paraspinal soft tissues appear normal. CONCLUSION: Postsurgical changes. No acute injury is seen.
  • Modality: CT
  • System: Spine
  • Findings: Technique: Multiplanar, multisequence imaging has been obtained through the cervical and thoracic spine. Findings: Cerebellar tonsillar ectopia of 20 mm with marked crowding of structures at the foramen Magnum. There is also ligamentous hypertrophy around the dens. Small disc bulges are seen at C4/5 and C6/7 indenting the ventral CSF space. There is a localized syrinx at the C7 level, measuring 8 mm in length and 2 mm in AP dimension. There is a mild prominence of the central canal above this. Left paracentral disc protrusion at T11/12 which mildly displaces the cord, without cord abnormality. There is also mild left foraminal stenosis at this level. Conclusion: Chiari malformation with localized syrinx at C7.​
Date Published: 27th Feb 2016
Source https://radiopaedia.org/cases/chiari-1-pre-and-post-decompression-surgery
Author Bruno Di Muzio
Permission
(Permission-reusing-text)		 http://creativecommons.org/licenses/by-nc-sa/3.0/

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Attribution-NonCommercial-ShareAlike 3.0 Unported (CC BY-NC-SA 3.0)

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