Neurosarcoidosis and Chiari I malformation
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Presentation
Ataxia.
Patient Data
Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.



Extensive edema and enhancement of the surface of the left cerebellar hemisphere are noted with additional enhancement of the pons. The cerebellar tonsils are low lying by ~12 mm, reaching below the posterior arch of C1.



MRI of the cervical spine demonstrates extensive syrinx without enhancement associated with a prominent chiari I malformation.
Case Discussion
This patient went on to have a posterior fossa decompression and biopsy of her posterior fossa meninges which revealed granulomatous inflammation compatible with sarcoidosis. This was confirmed clinically.