Female, 50 years old, with headaches and history of Chiari malformation. Diffusion-weighted sequences are obscured by metallic artifact, but no definite restricted diffusion is suspected. Numerous scattered foci of T2 hyperintensity are seen in the bilateral cerebral hemispheres without mass effect. No evidence of intracranial hemorrhage is seen. No abnormal extra axial fluid collections are detected. The ventricles are normal in size and morphology. Incidental note is made of a partially empty sella.The cerebellar tonsils are pointed and descend at least 10 mm below the plane of the foramen magnum. Fairly robust CSF flow is seen through the anterior foramen magnum, but no appreciable flow is seen posteriorly along the cerebellar tonsils.A focus of T2 hyperintensity is evident within the central spinal cord at the C2 level. This lesion measures up to 2 mm in diameter and 4 mm in craniocaudal length. The remainder of the spinal cord is unremarkable.Spinal alignment is anatomic. Vertebral body morphology and signal characteristics are normal. No evidence of significant degenerative disc disease, spinal canal or neuroforaminal stenosis is seen.
1.Findings compatible with Chiari I malformation with pointed cerebellar tonsils which descend at least 10 mm below the plane of the foramen magnum. No CSF flow is detected along the posterior foramen magnum or around the cerebellar tonsils.2.A 2 x 4 mm focus of T2 hyperintensity within the central spinal cord at the C2 level is compatible with a very small syrinx. The remainder of the visualized spinal cord is unremarkable.3.No other abnormalities of the cervical spine are seen.