Male, 49 years old, with numbness, Chiari seen on previous MRI. Brain:The right cerebellar tonsil is peglike in morphology and descends 7-8 mm below the level of foramen magnum. The left cerebellar tonsil maintains a more normally rounded configuration but still distends 5 to 6 mm below the level of the foramen magnum. However, the CSF space at the level of foramen magnum is not particularly crowded, and on CSF flow imaging, fairly robust biphasic flow is demonstrated both anteriorly and posteriorly.Elsewhere in the brain, a few scattered small foci of nonspecific FLAIR hyperintensity are seen within the cerebral parenchyma. No edema or mass effect is detected. No intracranial hemorrhage or any abnormal extra-axial fluid collection is seen. The ventricles are normal in size and morphology. Bone marrow signal characteristics are within normal limits. A defect of the nasal septum is noted incidentally.Thoracic spine:As assessed on sagittal T2-weighted images, the spinal cord demonstrates normal signal intensity and morphology. No focal lesions are seen. No evidence of any syrinx is detected. Spinal alignment is anatomic. Vertebral body heights are preserved. Mild endplate degenerative changes are seen with small scattered disc protrusions. No high-grade spinal canal or foraminal stenosis is suspected.
1.Findings are seen compatible with Chiari I malformation. However, the CSF space at the foramen magnum is not particularly crowded, and CSF flow imaging shows robust biphasic flow both anteriorly and posteriorly.2.No additional significant intracranial findings are seen.3.On limited imaging of the thoracic spine, no additional spinal cord abnormalities are detected.