Name of the Patient : Abc Xyzath Ylmn / M / 35 yrs.
Referred by : Dr. Abc Xyzngsarkar.
Examination : M.R.I. of the Cervical Spine.
CLINICAL PROFILE :
C/O neck pain with paresthesias since 1 year and difficulty in walking.
M.R.I of the cervical spine was performed using the following parameters :
4 mm thick T1 Weighted and T2 Weighted sagittal images.
5 mm thick T1 Weighted and Fast Scan (T2 *) axial images.
3 mm thick T1 Weighted coronal images.
There is loss of normal cervical lordosis and loss of water
content of the cervical intervertebral discs.
There is partial occipitalization of the atlas.
There is inferior herniation of the cerebellar tonsils through the foramen magnum with the tip of the tonsils lying at the C2 vertebral level. The posterior portion of the dens is seen to indent the anterior aspect of the cervico-medullary junction.
There is a well-marginated, CSF signal intensity lesion on all the pulse sequences in the cervical spinal cord, centrally at the C2 vertebral level extending upto the C2-C3 disc level. This lesion represents a focal syrinx. No perilesional cord edema is noted.
Minimal posterior disc bulges are noted at the C2-C3, C3-C4 and C4-C5 levels. A left paracentral disc herniation is seen at the C5-C6 level.
The left vertebral artery appears smaller than the right and may be a normal variant.
The cervical vertebral bodies show normal signal intensity. The joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.
1. Partial occipitalization of the atlas.
2. Inferior herniation of the cerebellar tonsils through the foramen magnum with a focal syrinx in the cervical spinal cord at the C2 vertebral level suggests a Chiari malformation.