Presentation
Neonate presenting with myelomeningocele for CNS survey.
Patient Data
Age: 1 month
Gender: Female
From the case:
Chiari II malformation
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findings:\u003c/p\u003e\u003cul\u003e\n\u003cli\u003eCrowded foramen magnum with the cerebellar tonsils and vermis seen displaced inferiorly.\u003c/li\u003e\n\u003cli\u003eSmall posterior fossa with a low attachment of the tentorium and low torcula.\u003c/li\u003e\n\u003cli\u003ePulled down brainstem with an elongated and low lying fourth ventricle.\u003c/li\u003e\n\u003cli\u003e\nTectal plate beaking.\u003c/li\u003e\n\u003cli\u003eAngulation of the aqueduct.\u003c/li\u003e\n\u003cli\u003eConcavity of clivus\u003c/li\u003e\n\u003c/ul\u003e\u003cp\u003eSupratentorial findings:\u003c/p\u003e\u003cul\u003e\n\u003cli\u003e\nHydrocephalus with colpocephaly.\u003c/li\u003e\n\u003cli\u003e\nThinned out corpus callosum.\u003c/li\u003e\n\u003cli\u003e\nfenestration of the falx with interdigitated gyri.\u003c/li\u003e\n\u003cli\u003eHeart shape incisura.\u003c/li\u003e\n\u003cli\u003eLarge massa intermedia of the thalamus.\u003c/li\u003e\n\u003c/ul\u003e","gb":"\u003cp\u003eInfra-tentorial findings:\u003c/p\u003e\u003cul\u003e\n\u003cli\u003eCrowded foramen magnum with the cerebellar tonsils and vermis seen displaced inferiorly.\u003c/li\u003e\n\u003cli\u003eSmall posterior fossa with a low attachment of the tentorium and low torcula.\u003c/li\u003e\n\u003cli\u003ePulled down brainstem with an elongated and low lying fourth ventricle.\u003c/li\u003e\n\u003cli\u003e\nTectal plate beaking.\u003c/li\u003e\n\u003cli\u003eAngulation of the aqueduct.\u003c/li\u003e\n\u003cli\u003eConcavity of clivus\u003c/li\u003e\n\u003c/ul\u003e\u003cp\u003eSupratentorial findings:\u003c/p\u003e\u003cul\u003e\n\u003cli\u003e\nHydrocephalus with colpocephaly.\u003c/li\u003e\n\u003cli\u003e\nThinned out corpus callosum.\u003c/li\u003e\n\u003cli\u003e\nfenestration of the falx with interdigitated gyri.\u003c/li\u003e\n\u003cli\u003eHeart shape incisura.\u003c/li\u003e\n\u003cli\u003eLarge massa intermedia of the thalamus.\u003c/li\u003e\n\u003c/ul\u003e"},"contributor_login":"farouk","case_id":58484,"case_key_image_id":36138493,"case_featured_at":"12 Apr 2018"},"current_user":null,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_pin":false}}
Infra-tentorial findings:
- Crowded foramen magnum with the cerebellar tonsils and vermis seen displaced inferiorly.
- Small posterior fossa with a low attachment of the tentorium and low torcula.
- Pulled down brainstem with an elongated and low lying fourth ventricle.
- Tectal plate beaking.
- Angulation of the aqueduct.
- Concavity of clivus
Supratentorial findings:
- Hydrocephalus with colpocephaly.
- Thinned out corpus callosum.
- fenestration of the falx with interdigitated gyri.
- Heart shape incisura.
- Large massa intermedia of the thalamus.
Case Discussion
The constellation of the supra and infra-tentorial CNS findings in addition to the myelomeningocele are of a Chiari II malformation.
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