Presentation
Headache and dizziness.
Patient Data
Hypoplasia of the right tentorium cerebelli, with medial herniation of the isthmus of the cingulate gyrus, slightly displacing the ipsilateral pulvinar anteriorly, and of the anterior part of the lingual gyrus, which is separated from the isthmus by the anterior calcarine sulcus.
Case Discussion
Intense headache, accompanied by bilateral tinnitus and dizziness for the past two weeks. She had taken betahistine, which alleviated the symptoms, but forgot to take it the day before - the symptoms relapsed and were not alleviated this time by the pill.
Physical exam was normal, except for nystagmus to the right. Marked improvement after receiving the Epley manoeuvre and an anti-dopaminergic agent.
Tentorial hypoplasia is an uncommon congenital anomaly. It is essential to recognise it, as the resultant herniation could be the possible source of neurological symptoms 1.
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