compression of brain [348.4] / Headache(784.0) [784.0] / Cervicalgia [723.1], Reason for Study: ^Reason: headaches , neck pain, found Chiari on CT scan. Evaluate for Chiari and CSF flow please History: headache neck pain Brain MRINo evidence of acute ischemic or hemorrhagic lesion.There is about 3 mm tonsillar herniation through the foramen magnum.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 paranasal sinuses and mastoid air cells are clear.C-spine MRIThe cranial-cervical junction is normal. There is normal cervical lordosis. The cervical spine alignment is anatomic. The vertebral body height is preserved. The bone marrow and end plates demonstrate a normal MR appearance. The signal of the visualized cord is normal. The epidural space, thecal sac, and spinal cord are preserved with no evidence of spinal canal/neural foraminal narrowing or myelopathy. The intervertebral discs demonstrate normal T2 intensity and height with no evidence of disc herniation. The paraspinal soft tissues are unremarkable.CSF flow studyPhase-contrast MR angiographies through the foramen magnum for to study of CSF flow demonstrated normal pulsatile bidirectional flow especially anterior aspect of spinal cord.Posterior aspect of spinal cord through the foramen magnum CSF flow also demonstrate first bidirectional flow.
1. No evidence of acute ischemic or hemorrhagic lesion.2. About 3 mm tonsillar herniation through the foramen magnum as described above.3. Normal C-spine MRI.4. Normal CSF flow study