Dizziness, near-syncope, headaches, nausea/vomiting, numbness/tingling in hands and feet, and feel "hot". Brain: The cerebellar tonsils extend up to 5 mm inferior to the foramen magnum and display pointed morphologies. Nevertheless, there is biphasic flow of cerebrospinal fluid across the foramen magnum, both anteriorly and posteriorly. There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma appears unremarkable. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.Cervical Spine: The spinal cord displays normal signal and morphology. There is lack of the usual cervical lordosis. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is unremarkable. There are small posterior disc-osteophyte complexes at multiple levels, but no significant spinal canal stenosis. The paravertebral soft tissues are unremarkable.
1. The cerebellar tonsils extend up to 5 mm inferior to the foramen magnum and display pointed morphologies, which can represent a manifestation of Chiari type 1 malformation. Nevertheless, there is biphasic flow of cerebrospinal fluid across the foramen magnum2. No evidence of syringohydromyelia.