Central sleep apnea with dropped breaths, hypotonia, developmental delay. Evaluate for atrophy vs mass vs other processes explaining clinical condition. There is increased crowding of the foramen magnum compared to the previous exam with pointing of the tonsils. The tonsils descend to the level of the posterior arch of C1 which is compatible with Chiari type I malformation. There is symmetric interval increase in size of the ventricles with proportionate increase in size of the sulci/subarachnoid spaces. Given that these are proportionally increased, this is favored to be secondary to parenchymal volume loss.There is normal myelination pattern for age. There are no focal lesions and no obvious structural abnormalities. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
1.Findings compatible with Chiari Type I malformation.2.Symmetrically increased ventricular size and sulci/subarachnoid spaces suspicious for global parenchymal volume loss.3.Normal myelination pattern for age.