Somnolence [R40.0], Reason for Study: ^Reason: anatomic abnormalities? Chiari? History: LOC concerning for seizure No evidence of acute ischemic or hemorrhagic lesion.There is about 22.6mm cerebellar tonsilar herniation through foramen magnum indicating Chiari I malformation.Associated cervical spinal cord syringomyelia from the level of C2 is also seen.The ventricles, sulci and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, or restricted diffusion/acute ischemia. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The mastoid air cells show fluid signal intensity and mucosal thickenings on bilateral maxillary sinuses, ethmoid sinuses, frontal sinus and sphenoid sinus.
1. Chiari I malformation with cervical spinal cord syringomyelia.2. No evidence of acute ischemic or hemorrhagic lesion.