There are numerous findings of intracranial hypotension, namely:
- biconvex margins of the dural venous sinuses with altered flow-voids
- enlarged pituitary gland (1 cm craniocaudal)
- decreased mamillopontine distance (2 mm)
- decreased pontomesencephalic angle (roughly 25 degrees)
- effacement of the supra-sellar cistern with descent of the optic chiasm which is draped over the pituitary gland
- descent of the midbrain with an elongated appearance on axial slices
- pons flattened on clivus
- cerebellar tonsillar ectopia
- slit-like third ventricle with descent and convex aspect of the infundibular and supra-optic recesses
Also noted are many very T2-hyperintense trans-spatial lesions visible in the intrinsic tongue muscles, behind the right mandibular ramus and in the right head extensor muscles, most likely representing venous or venolymphatic malformations.
Unrelated right cerebellar developmental venous anomaly.