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Inferior descent of the cerebellar tonsils by approximately 12 mm bilaterally, with sagging midbrain and effacement of the prepontine cistern. There is crowding of the suprasellar cistern, with the optic chiasm draped over the budgetary gland. The pituitary is plump and protrudes approximately 4 mm above the sella. No focal pituitary lesions are demonstrated, and the posterior pituitary bright spot is preserved.
Post-contrast images demonstrate diffuse, smooth enhancement of the dura, with no nodularity or focal mass lesion. No dural venous sinus and gorge within the cranial cavity, but the anterior epidural venous plexus is in the upper part of the neck are engorged . The ventricles and sulci age appropriate. No diffusion restriction.
The findings are highly suggestive of intracranial hypotension.