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Chiari I malformation with syrinx

Case contributed by Ammar Haouimi
Diagnosis certain

Presentation

Chronic neck pain with numbness of both hands.

Patient Data

Age: 50 years
Gender: Female

The cerebellar tonsils are herniated through the foramen magnum (10 mm below the foramen magnum) with obliteration of the cisterna magna. A central cystic cavity of the cervical spinal cord of low signal intensity on T1WI, and high signal intensity on T2WI, extending from C2 up to C6/C7 in keeping with a syrinx. A T2 hypointense area is noted within the syrinx, not visible on axial gradient echo representing most likely a proteinaceous material. A C1/C2 vertebral fusion is noted.

A lacunar infarct of the pons is noted as a small focal area of low signal on T1WI, and high signal on T2WI

Case Discussion

MRI features of a Chiari I malformation with associated cervical cord syrinx and C1-C2 vertebral fusion.

 

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