Severe abdominal pain. Evaluate migraine. The cerebellar tonsils extend up to 9 mm inferior to the foramen magnum, where there is crowding of the soft tissues. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There are a few scattered punctate foci of T2 hyperintensity within the subcortical white matter. The brain parenchyma otherwise appears unremarkable. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift. The skull and extracranial soft tissues are unremarkable.
1. Low-lying cerebellar tonsils are suggestive of Chiari I malformation.2. No evidence of intracranial hemorrhage, mass, or acute infarct.3. A few scattered punctate foci of T2 hyperintensity within the subcortical white matter, which are non-specific.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.