reccurent sub arachnoid hemorrhage with paraparesia. cerebra | Figure 1

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Case Discussion

Recurrent subarachnoid hemorrhage with paraparesis. Cerebral MRI normal. We have only 0.4 T. Can it be dural fistula? How can we rule it out?

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Sagittal T2 MRI of the upper (image 1) and lower (image 2) spine show a large holocord syrinx (arrowhead) caused by a Chiari I malformation (arrow). Chiari I malformation is characterized by inferior migration of the cerebellar tonsils through the foramen magnum. When a Chiari I malformation is present, the cerebellar tonsils can be pointed having a peg shape. A syrinx occurs with greater degrees of compression. Typically, if a syrinx is present, it is small and limited to a short segment of the spinal cord.