The magnetic resonance imaging process involves Magnets, Resonance (vibration), and Imaging (creating pictures). The MRI is one of the main diagnostic tools in identifying Chiari.  Following, are MRI's from the Editor, both before and after surgery, plus excerpts from the Radiologist's original report.



Before Surgery

cerebellar-tonsils     pre-surgery-syrinx

Excerpted From The Radiologist's Report -

MRI OF THE CERVICAL SPINE WITHOUT CONTRAST

History:  Right-sided neck pain; headaches; abnormal X-ray
The cervical vertebrae appear normal in stature, alignment, and signal intensity; however, the odontoid process and anterior arch of C1 appear high on the sagittal images, suspicious for basilar impression....

...However, the cerebellar tonsils are ectopic, extending about 1.5 cm below the foramen magnum.  In addition, a syrinx is present which most prominent at the C2-C3 level where it has a maximum diameter of about 9 mm.  On some of the images, the syrinx is barely perceptible, although there is a re-expansion at the T2-T3 level where it measures about 4 mm in diameter....

IMPRESSIONS:

  • The findings are consistent with a Chiari I malformation associated with a syrinx which is most prominent in the upper cervical region, although there is also a prominent are of expansion in the upper thoracic cord.
  • The outside radiographs were not available for correlation; basilar impression may be present.
  • No disc herniation or spinal stenosis.
  • Incidental note was made of the right vertebral artery coursing anterior the the spinomedullary junction at the foramen magnum.   This is of questionable clinical significance.


After Surgery (5 yrs. post-op)

post-surg-syrinx        scoliosis


NOTES:

  • Even years after surgery, the syrinxes are still present, however they are smaller and no longer are pushing the spinal cord out.
  • The cerebellar tonsils are rounder and higher in the skull.
  • Scoliosis (abnormal curvature of the spine) is common with syringomyelia, even in adults. The MRI on the right shows scoliosis in the neck and upper back.
  • To learn about the diagnostic process of MRI see our Diagnostic Presentation



Practical Tips for Patients