Female, 11 years old. Reason: h/o Chiari visualized on OSH MRI and CT at UCMC; r/o cervical syrinx History: headache Examination demonstrates at least 10 mm of downward herniation of the mildly pointed cerebellar tonsils with resultant crowding of the foramen magnum, compatible with Chiari 1 malformation. CINE phase contrast CSF flow sequence shows biphasic CSF flow with ample flow ventrally along the brainstem and cervicomedullary junction. There is somewhat diminished biphasic flow posteriorly along the foramen magnum, specifically at the level of the cerebellar tonsils, as well as through the fourth ventricle and cerebral aqueduct.There is straightening of the normal cervical lordosis. The vertebral body heights are preserved. The intervertebral discs demonstrate normal T2 intensity and height with no evidence of disc herniation. The bone marrow and end plates demonstrate a normal MR appearance. The epidural space, thecal sac, and spinal cord are preserved with no evidence of spinal canal/neural foraminal stenosis, cord compression or myelopathy. There is no abnormal signal within the cord to suggest syringomyelia.The paraspinal soft tissues and musculature are unremarkable.
Redemonstration of known Chiari 1 malformation with associated diminished biphasic CSF flow posteriorly at the level of the foramen magnum but without evidence of syringohydromyelia.