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For the age of the patient, the ventricles are diffusely small, and the sulci are particularly not prominent (diffuse brain swelling)
Moreover, there is slight herniation of the cerebellar tonsils through the foramen magnum (3 mm). The suprasellar cistern is almost erased. There is a downward deformity of the splenium (droopy penis sign).
After IV gadolinium administration, there is an intense & diffuse pachymeningeal enhancement.
The presentation is compatible with spontaneous intracranial hypotension. This patient also had a subdural collection at the right upper convexity.