“ This is typically an incidental finding in adults. It may be acquired secondary to increased intracranial pressure, decreased intraspinal ...
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This is typically an incidental finding in adults. It may be acquired secondary to increased intracranial pressure, decreased intraspinal pressure or decreased posterior fossa volume. May cause chronic headache or cranial nerve palsy. It is the commonest cause of a syrinx (not associated with myelomeningocele). Syndrome associations include craniosynostosis, Klippel-Feil syndrome and Sprengel deformity.
MRI
• Sagittal reformats of the craniovertebral junction are most useful.
• Expect an isolated hindbrain abnormality, normal cortex.
• Look for pointed, peg-shaped cerebellar tonsils protruding >5 mm below the foramen magnum (opisthion-basion line).
• Normal appearance of the fourth ventricle.
• Additional findings may include: hydrocephalus (up to 40%), syrinx (up to 75%), tethered cord, craniovertebral segmentation anomalies.
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