Paresthesia. Brain: The cerebellar tonsil extend up to approximately 15 mm inferior to the foramen magnum and have pointed morphologies, in association with a relatively small posterior fossa. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is nonspecific minimal anterior periventricular white matter T2 hyperintensity and a punctate focus of T2 hyperintensity in the right anterior subinsular white matter. There is also a prominent right inferior basal ganglia region prominent perivascular space. The ventricles are normal in size and configuration. There is no midline shift. The major cerebral flow voids are intact. The orbits are grossly unremarkable. There is moderate mucosal thickening in the left maxillary sinus.Cervical Spine: There is a long segment syrinx that extends from the C2 level to the imaged portions of the upper thoracic spinal cord, measuring up to 11 mm in width. The vertebral column alignment is within normal limits. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is unremarkable. There is degenerative spondylosis at C6-7, but no significant spinal canal stenosis. The paravertebral soft tissues are unremarkable.
Chiari type 1 malformation with long segment syrinx that extends from the C2 level to the imaged portions of the upper thoracic spinal cord.