40 years, Female, increased headache, history of generalized epilepsy. Brain parenchyma appears within normal limits. No significant parenchymal T2/FLAIR signal abnormality. No evidence of cortical dysplasia, gray matter heterotopia, or other lesions to suggest seizure focus. Bilateral hippocampi are symmetric in size and signal characteristics with preserved internal architecture. Cerebellar tonsils are borderline low measuring up to 4 mm below the foramen magnum without evidence of Chiari malformation. No restricted diffusion to suggest acute ischemia. No intracranial hemorrhage. No intracranial mass effect, midline shift, or herniation. The ventricles are within normal limits in size and configuration. No abnormal parenchymal or meningeal enhancement. Major flow-voids are preserved.Sella and orbits are grossly within normal limits. Paranasal sinuses and mastoid cells are clear. Bone marrow signal and extracranial soft tissues are within normal limits.
1. MRI brain is essentially unremarkable.2. Borderline low cerebellar tonsils without clear evidence of Chiari I malformation.