Clinical History
The patient was referred with a swelling at the back of the craniocervical junction and hydrocephalus at birth.
Imaging Findings
The patient was referred with a swelling at the back of the craniocervical junction and hydrocephalus at birth. A cerebral MRI study was performed with SE T1, FSE T2, and FLAIR sequences in three planes on a 1.5 T MR scanner. MRI study was the first diagnostic modality applied for tha patient. A small posterior fossa volume with low-lying transverse sinuses was detected. There was a heart-shaped incisura with hypoplastic tentorium cerebelli. Additional posterior fossa findings were tectal beaking, creeping of the cerebellar hemispheres around the brain stem, and elongated tube-like narrowed inferiorly located fourth ventricle. A triventricular hydrocephaly was present, associated with colpocephaly. A coincidental cavum septum pellucidum et vergae variation was also detected apart from the pathological findings. Corpus callosum was dysgenetic. Herniation of dysplastic medulla oblongata and upper cervical spinal cord through an osseous defect of the lower occipital bone and posterior elements of the C1 and C2 cervical vertebrae was the major MRI finding, which was also correlated during the surgery. The patient underwent surgery for the repair of meningocele, and he is still under the medical control.
Differential Diagnosis List