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Neurosarcoidosis and Chiari I malformation

Case contributed by Frank Gaillard
Diagnosis certain

Presentation

Ataxia.

Patient Data

Age: 18 years
Gender: Female

Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

MRI brain

mri

Extensive edema and enhancement of the surface of the left cerebellar hemisphere are noted with additional enhancement of the pons. The cerebellar tonsils are low lying by ~12 mm, reaching below the posterior arch of C1. 

MRI of the cervical spine demonstrates extensive syrinx without enhancement associated with a prominent chiari I malformation. 

Case Discussion

This patient went on to have a posterior fossa decompression and biopsy of her posterior fossa meninges which revealed granulomatous inflammation compatible with sarcoidosis. This was confirmed clinically. 

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