C1 meningioma, postoperative evaluation There are postsurgical changes of resection of previously seen meningioma at the right C1 level. There appears to be total resection without evidence of residual tumor. There is prominent dural and epidural enhancement which is likely reactive. No evidence of intraspinal hematoma. There is minimal fluid in the posterior upper paraspinous soft tissues related to recent surgery.Again seen is evidence of prior wide laminectomies from C4 to C6 with posterior spinal fusion hardware at these levels including lateral mass screws and paraspinous rods. Susceptibility artifact slightly limits evaluation. Spinal canal is however well decompressed at these levels. Multilevel degenerative changes are again seen including multilevel disc osteophyte complexes. There remains mild spinal canal stenosis at the C2-C3 level above the laminectomy and at the C7-T1 level, and to a slightly greater degree at the T1-T2 level where there is a disc extrusion and up to moderate spinal canal stenosis similar to prior. Abnormal T2 signal at the C4-C5 level is unchanged and associated with mild volume loss consistent with myomalacia. No new cord signal abnormality. There is multilevel neural foraminal narrowing relatively worse at the T1-T2 level where there is mild to moderate left greater than right neural foraminal narrowing.
1. Interval postsurgical changes of right lateral C1 meningioma resection without evidence of residual tumor.2. Postsurgical changes related to spinal canal decompression from C4 to C6 with posterior spinal fusion. Multilevel degenerative changes as before including up to moderate spinal canal stenosis at the T1-T2 level primarily related to disc extrusion.3. Myelomalacia at the C4-C5 level, as seen before. No new cord signal normally.