Aqueduct stenosis and Chiari I malformation
4 week history of headache, nausea and tremor of both hands
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Beautiful demonstration of septum pellucidum perforation, with dilatation of the 3rd and lateral ventricles and a focal septum in the aqueduct causing obstruction, as evidenced by a lack of flow void. The ballooned 3rd ventricle erodes the dorsum sellae causing marked deformity of the hypothalamus, pituitary stalk and pituitary gland.
The sagittal series demonstrate typical Chiari I malformation without syringomyelia. Note the dysplastic (pyramidal shaped) cerebellar tonsils protruding through the foramen magnum.
Typical findings of long standing aqueduct stenosis presenting in a young adult with associated Chiari I malformation. The tonsils are dysplastic, not just protruding as might be expected with obstructive hydrocephalus