Presentation
Chronic neck pain with numbness of both hands.
Patient Data
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.