Chiari malformation with headaches and back pain. Cervical Spine: There is an enlarged and partially-empty sella. The cerebellar tonsils are low lying and 9 mm, there is apparent low obex positioning, and there is paucity of cerebrospinal fluid flow across the foramen magnum, both anteriorly and posteriorly. There is no evidence of syringohydromyelia. There is straightening of the normal cervical lordosis. The vertebral body heights and intervertebral disc spaces are grossly preserved. There bone marrow signal is unremarkable. There is mild degenerative spondylosis in the cervical spine, which is most pronounced at C3-4, where there is a prominent disc osteophyte complex that slightly indents the spinal cord. The paraspinal soft tissues are unremarkable. Thoracic Spine: The alignment of the thoracic spine is normal. The vertebral body heights and intervertebral disc spaces are preserved. There are no significant degenerative changes. There is no spinal canal stenosis or neural foraminal narrowing in the thoracic spine. The vertebral bone marrow signal is normal. The spinal cord signal and morphology is normal. The paraspinal soft tissues are unremarkable.
1. Partially-empty sella, low lying cerebellar tonsils and obex position, and paucity of cerebrospinal fluid flow across the foramen magnum, suggestive of pseudotumor cerebri perhaps superimposed upon Chiari 1 malformation.2. No evidence of syringohydromyelia. 3. A disc osteophyte complex at C3/4 slightly indents the spinal cord.