Case Notes
History
11 yo female with history of Langerhans's histiocytosis now presents with headaches, unsteady gait and visual blurriness.Exam
MR flair
Prior Study
Pre and or post head CT1. Nearly normal head CT other than subtle, nonspecific, hypodensity in the deep cerebellum on both sides and low tonsillar position at least reaching the plane of the foramen magnum.
Sagittal MR
1. Abnormal nonspecifci parenchymal hypointensity in the deep central cerebellar hemispheres bilaterally and also in the right cerebellar tonsil.
2. The cerebellar tonsils are displaced downward at least 9mms below the plane of the foramen magnum, which exceeds normal variation, especially in the context of apparent cerebellar edema.