49-year-old female with headache, Chiari, rule out CSF hypotension Compared to prior MRI brain study dated 10/27/2014 there has been improvement in cerebellar tonsillar descent from 9 mm to 5 mm on the current study. There is no significant dural enhancement, prominence of the venous sinuses or sella, or significant brain sagging to indicate intracranial hypotension. There is interval increase in CSF space involving the suprasellar cistern. The CSF flow sequences are technically degraded, however there is good CSF flow ventrally at the foramen magnum and mildly diminished CSF flow posteriorly. Overall these findings suggest improvement in previously seen intracranial hypotension.The brain parenchyma otherwise is unremarkable. There is no evidence of restricted diffusion. No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.
Compared to 10/27/2014, findings including improvement in cerebellar tonsillar descent suggest improvement in intracranial hypotension. No definite evidence of intracranial hypotension is however demonstrated on the current study. The cerebellar tonsils remain mildly low (5 mm below the foramen magnum) with mild reduction in CSF space/CSF flow dorsally at the foramen magnum; these changes may reflect an underlying component of mild Chiari 1. 