New daily persistent headache (ndph) [G44.52], Reason for Study: ^Reason: Please examine re structural abnormality, especially of craniocervical junction History: New daily headache, wakes from sleep No evidence of acute ischemic or hemorrhagic lesion on the scan.There is about 5 mm downward herniation of bilateral cerebellar tonsil through the foramen magnum.There is no evidence of syrinx.The ventricles, sulci and cisterns are symmetric and unremarkable. 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.CSF flow study through the foramen magnumBidirectional CSF flow was seen through the foramen magnum anterior to craniocervical junction and posterior to the cerebellar tonsil.
1. About 5mm downward herniation of bilateral cerebellar tonsil through the foramen magnum.2. No evidence of acute ischemic or hemorrhagic lesion. No mass lesion.3. Normal CSF flow study through the foramen magnum.