sb/hs/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Slmn / M / 45 yrs.
Referred by : Dr. Abc Xyznghal.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neck pain with pain radiating to the RUE with paresthesias.

EXAMINATION :

M.R.I of the cervical spine was performed using the following parameters :

5 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and Fast Scan (T2 *) axial images.

OBSERVATION :

There is loss of water content of the cervical intervertebral discs.

There is cerebellar tonsillar herniation through the foramen magnum with the tip of the tonsils lying at about the C1-C2 level. The tip of the tonsils appear pegged.

There is seen a CSF signal intensity lesion on all the pulse sequences in the cervico-dorsal spinal cord, centrally and extending over the C3-C4 to D1-D2 levels. This lesion represents a syrinx.

A small postero-central disc herniation with peridiscal osteophytes is seen at the C4-C5 level.

A small posterior disc bulge is noted at the C5-C6 level.

The cervical vertebral bodies show normal signal intensity. The joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.
..2/.







There is no extrinsic cord compression.

The atlanto-axial region is unremarkable.

IMPRESSION :

The MRI features suggest cerebellar tonsillar herniation through the foramen magnum with a syrinx in the cervico-dorsal spinal cord, centrally, extending over the C3-C4 to D1-D2 levels. These features suggest a Chiari malformation.