Chiari I malformation

Clinical History: 
This 50-year-old female, who reported a history of being in a motorcycle accident approximately two years ago, complained of a one year history of severe headaches and neck pain. An MR examination revealed degenerative disease in the cervical spine associated with a Type 1 Chiari Malformation.

Diagnosis:
Brainstem glioma.

MR Technique: 
Scans were acquired on a 1.5 T Siemens MR unit. (A, B) Sagittal pre-constrast T1-weighted fluid-attenuated inversion recovery (FLAIR) (TI/TR/TE 799.8/2000/10ms, scantime 3:56 min:sec) images as well as (C) T2-weighted turbo spin echo (TR/TE 3200/105ms, scantime 2:40 min:sec) images were obtained. Images were acquired with a slice thickness of 3 mm.

Imaging Findings:
The cerebellar tonsils are pointed in configuration and extent slightly below the level of the posterior arch of C1. Little, if any, CSF surrounds the spinal cord or cerebellar tonsils at the level of the foramen magnum. There is no additional evidence of medullary kinking, beaking of the tectum, or a towering appearance to the cerebellum to suggest a Chiari 2 malformation. A degenerative disk bulge is noted at C4-5, and more extensive degenerative changes were noted inferiorly within the cervical spine.