sb/ke/rg/nl

Name of the Patient : Abc Xyzi lmn / F / 32 yrs.
Referred by : Dr. Abc Xyzwant.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

Known C/O Arnold Chiari II malformation with syringomyelia.
H/O TP Shunt done in 0000 with subsequent removal of shunt tube after few months.
C/O progressive paraparesis since 2 months.

EXAMINATION :

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.

OBSERVATION :

There is probable occipitalization of the C1. The clivus is more horizontally oriented than normal. There is beaking of the cerebellar tonsils with cerebellar tonsillar ectopia.

There is a CSF signal intensity lesion on all the pulse sequences in the cervical spinal cord, centrally and more to the left of the midline, extending from the C2 to atleast the D3-D4 level. This lesion represents a syrinx.

The cervical intervertebral discs show loss of water content.

The cervical vertebral bodies show normal signal intensity. The joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.

>
The dorsal spine was screened with 6 mm thick T1 Weighted coronal and 4 mm thick T1 Weighted sagittal images. There is scoliosis of the dorsal spine with convexity to the right. Slight decrease in calibre of the upper dorsal spinal cord is noted. The syrinx is noted upto the D4/D5 level. The D7 vertebral body is wedged, centrally, ? due to previous trauma.

Screening T2 Weighted images of the brain, reveal prominent cerebellar folia. Mild fullness of both the lateral ventricles is noted. The third and fourth ventricles are normal. No obvious parenchymal lesion is noted.

IMPRESSION :

1. Post-TP-Shunt status.

2. Beaked cerebellar tonsils with a syrinx in the cervico-dorsal spinal cord suggests a Chiari malformation. The syrinx is noted upto the D4/D5 vertebral level.

3. There is no evidence of hydrocephalus.

No previous investigations were available for comparison.